Anal Cancer

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Early Detection, Diagnosis, and Staging TOPICS

Can anal cancer be found early?

Many cases of anal cancer can be found early in the course of the disease. Anal cancers develop in a part of the digestive tract that your doctor can easily see and reach. Many early anal cancers have symptoms that should make you see your doctor. Unfortunately, some anal cancers may not cause symptoms until they reach an advanced stage. Other anal cancers may cause symptoms like those caused by diseases other than cancer. This may cause a delay in their diagnosis.

A digital rectal exam (DRE) will find some cases of anal carcinoma early. This test is sometimes used to look for prostate cancer in men (because the prostate gland can be felt through the rectum). The rectal exam is also done routinely as part of a pelvic exam on women. In this exam, the doctor inserts a gloved, lubricated finger into the anus to feel for unusual lumps or growths. If you are at increased risk for anal cancer, ask your doctor whether more frequent exams are needed.

The odds that anal cancer can be found early depend on the location and type of the cancer. Cancers that begin higher up in the anal canal are less likely to be found early. Melanomas tend to spread earlier than other cancers making it more difficult to diagnose in an early stage.

For people at high risk for anal intraepithelial neoplasia (AIN) some experts recommend screening with anal cytology testing. This test is also called an anal Pap test or anal Pap smear because it is much like a Pap test for cervical cancer. The anal lining is swabbed, and cells that come off on the swab are looked at under the microscope. People at increased risk for AIN include men who have sex with men (regardless of HIV status), women who have had cervical cancer or vulvar cancer, anyone who is HIV-positive, and all transplant recipients.

The anal Pap test has not been studied enough to know how often it should be done, or if it actually reduces the risk of anal cancer. Some experts recommend that the test be repeated yearly in HIV-positive men who have sex with men, and every 2 to 3 years if the men are HIV-negative. Patients with positive results should be referred for a biopsy. If AIN is detected, this condition should be treated.

Last Medical Review: 01/02/2013
Last Revised: 01/02/2013