Anal Cancer Screening

Screening tests help to detect early signs of cancer before symptoms appear. Anal cancer screening is not recommended for everyone but is most useful in people who are at higher risk for anal cancer. You should undergo anal cancer screening if you have any of the following factors:

  • Human immunodeficiency virus (HIV)
  • A history cervical, vaginal, or vulvar cancer or high-grade dysplasia.
  • A history of persistent cervical HPV 16 infection
  • Anal warts
  • Immunosuppression therapy, or treatment for autoimmune conditions such as rheumatoid arthritis, lupus, Crohn’s disease or ulcerative colitis.
  • History of anal sex
  • Received an organ transplant

If you have factors that increase your risk for anal cancer, we can help. Get screened at Roswell Park. Call 1-800-ROSWELL or fill out the form below to get started.

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What tests are used for anal cancer screening?

Screening for anal cancer can detect early signs of cancer such as abnormal lumps or lesions. Screening involves one or more of the following simple tests:

  • Digital anal rectal exam. A healthcare provider inserts their gloved finger into the anus to feel the wall of the anus for any lumps, warts or ulcerations.
  • Anal cytology (anal Pap test). Like the Pap test to screen for cervical cancer, this test collects cells from the anus to be examined by a pathologist for any abnormalities in the cells.
  • High resolution anoscopy. A small plastic tube is inserted into the anus to guide a special microscope called a colposcope allowing your healthcare provider to view the anus. If an abnormal area is seen, a biopsy (tissue sample) can be taken with these tools.

What do the results mean?

If your anal cytology detects any abnormal lesions or precancerous cells in the anus, the pathologist will further identify and assess the abnormality to help determine your next steps. Not all abnormalities (called dysplasia) mean cancer. Anal cytology results are often reported as:

  • Low-grade squamous intraepithelial lesions (LSIL). These are mild abnormalities and only very rarely do they become cancer.
  • High-grade squamous intraepithelial lesions (HSIL). These are moderate to severe abnormalities. These can progress to cancer over time.
  • Squamous cell cancer. Both LSIL and HSIL describe abnormal areas on the top of the skin in the anus, with HSIL being more abnormal. Once the abnormality spreads below the top layer, it is considered anal cancer.
  • Atypical squamous cells of undetermined significance (ASCUS). These cells appear abnormal, but they are not necessarily precancerous and may be a result of another cause, such as infection or inflammation.

Your next steps after anal cancer screening

While only a very small number of people with abnormal cytology will develop anal cancer, providers have no way of knowing who will progress to cancer. Close monitoring helps to detect any cancers early when it is most treatable.

Your follow up care will depend on your test results and whether you have other health issues. For some abnormalities, your doctor will advise you to repeat the cytology testing a few months later. Some people with HSIL results will need treatment of the abnormal areas, which may include topical medications, cryotherapy (freezing the area), laser therapy or surgery.

Treatment for anal cancer