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Anal Cancer (cont.)

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What are the symptoms and signs of anal cancer?

The symptoms and signs of anal cancers may include one or more of the following:

  • A lump or mass near the anus
  • A tumor or lump found on self-examination
  • Anal bleeding
  • A sense of pressure or foreign body sensation in the anal area
  • A change in bowel habits, such as constipation, incontinence (bowel leakage), and/or diarrhea
  • Anal discharge, which may be jelly-like and comprised of mostly mucus (It may also have a white or yellow appearance.)
  • Yellow discharge or a white discharge from anus
  • Mucus in stool
  • Itchy anus: Anal pruritus is a condition where the anus feels itchy. Some people who get anal cancer report having an itching anus. However, there are a number of other conditions that can cause an itchy anus, including diet, medications, and bowel leakage.
  • Painful defecation, anal pain, or pain in the perianal area

Many of these symptoms are easily mistaken for hemorrhoids. When first encountered, these symptoms are best evaluated by a health care professional. Even if a person has known hemorrhoids, a change in such symptoms and signs, such as their failure to resolve or a worsening, should also prompt examination.

Most anal cancer is found at an early or localized stage. In the unfortunate event that the disease is already spread outside of the anus, then symptoms and signs of more advanced disease can develop. These can include

What's involved with anal cancer screening (early detection)?

Looking for a disease or condition in people with no symptoms or signs is called screening. Screening is performed to find cancers at an early stage when treatment can be most beneficial. As anal cancer is rare, routine screening of the general public for this condition is not recommended.

In groups at higher risk for anal cancer and especially precancerous lesions called anal intraepithelial neoplasia (AIN), screening is appropriate. This includes men who have sex with men regardless of HIV status, women with histories of cervical and vulvar cancers, all HIV positive patients, post-transplant patients on immunosuppressive medicine, and those with a history of anal warts. Anal warts are not themselves considered precancerous, but imply HPV infection is present. Certain dangerous HPV subtypes may indicate the presence of cancer or lead to cancer development.

The screening technique for AIN is called an anal pap smear and uses the same technique used for women's pap smears. A swab is taken from the anal canal and a smear from the swab is submitted for microscopic evaluation by cytology technique. More recently, lab techniques are used to measure the presence and levels of the dangerous HPV (16 and 18) subtypes or the presence of mutations.

Screening frequency recommendations are still being established. For now, men who have sex with men and are HIV negative should be screened every two to three years. If they are HIV positive, then they should be screened yearly. If an anal pap smear is positive for AIN, the patient should be referred to a surgeon for a biopsy.

Medically Reviewed by a Doctor on 4/28/2017



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