Anal Cancer: Who Is at Risk, the Signs, Tests, Treatment and Prevention

The anus is the opening at the end of the large intestine, where stool (poop) leaves the body; it is formed partly from the outer layers of skin and partly from the intestine. Anal cancer forms in its tissues.

Who is more likely to get it

Anyone can, but the risk is higher if you:

• have an infection with high-risk HPV, especially certain types — most anal cancers are related to HPV;
• have a weakened immune system, from HIV or from medicines taken after an organ transplant;
• have had vulvar, vaginal or cervical cancer;
• have many sexual partners;
• have anal sex;
• smoke cigarettes.

Signs and symptoms

• bleeding from the anus or rectum;
• a lump near the anus;
• pain or pressure around the anus;
• itching or discharge;
• a change in bowel habits — narrower stools, going more often, or bowel incontinence.

Diagnosis

Your provider will take your medical history and family health history, and may:

• do a digital rectal exam (DRE) — feeling the lower rectum with a lubricated, gloved finger for lumps or anything unusual;
• order tests of the anus and rectum:
• • anoscopy, using a short, lighted tube (an anoscope); a high-resolution anoscopy adds a magnifying colposcope;
  • proctoscopy, using a thin tube with a light and lens;
  • an endo-anal or endorectal ultrasound, with a probe inserted into the rectum;
• take a biopsy during an anoscopy or proctoscopy.

Treatment

Radiation therapy, chemotherapy and surgery. Which you get depends on how advanced the cancer is, your overall health, and your preferences.

Prevention

• Get the HPV vaccine.
• Don't smoke — ask your provider for help quitting.
• It is not known whether condoms prevent anal HPV infection, but using latex condoms every time you have sex helps prevent HIV, a risk factor, and other sexually transmitted infections. If you or your partner is allergic to latex, use polyurethane condoms.
• Adults with HIV should have an anal cancer screening every year. It looks for lumps, burning and precancer cells (cells that could become cancer), includes a digital rectal exam, and if anything unusual is found, leads to an anoscopy or high-resolution anoscopy.

Sources

Based on "Anal Cancer," MedlinePlus, U.S. National Library of Medicine; a work of the United States government in the public domain.