Anal Pap Smear (Anal Cancer Screening)

Just like a Pap Smear, an Anal Pap Smear is used as Anal Cancer screening for cancer associated with human papillomavirus (HPV). 

Anal Cancer & Human Papillomavirus (HPV)

Anal cancer is not a common cancer. However studies have found that person who engages in receptive anal sex, both heterosexual and men who have sex with men (MSM), have a much higher risk of developing anal cancer. 

90% of all anal cancers in the world is caused by Human Papilloma Virus (HPV), the same virus that causes cervical cancer in women. The risks associated with developing anal cancer include:  

• Receptive anal intercourse
• HIV positive status
• Tobacco smoking 

A recent 2018 study that looked at all the evidence so far showed that 85% of all anal cancers in HIV-negative individuals are happen mostly because of the HPV 16 strain of the HPV virus. In HIV-positive individuals who have anal cancers, HPV 16 still played a significant role, but was not the only HPV strain detected.  

So how do I know if I have anal cancer?

In its early stages, anal cancer often has no obvious symptoms. In later stages, symptoms that may be experienced by some people are: 

• blood or mucus in stools (faeces) or on toilet paper 
• itching, discomfort or pain around the anus
• a feeling of fullness, discomfort or pain in the rectum
• a lump near the edge of the anus
• ulcers around the anus
• difficulty controlling bowels

So what should I do to screen for anal cancer if I’m at risk?

First of all, you should consult your doctor and if your doctor thinks that you are at risk of developing anal cancer, he will advise you to do a HPV high-risk group test which will detect the common high-risk HPV strains that can cause cancer, especially HPV 16/18. This is because as studies have shown 90% of anal cancers are due to high-risk HPV strains.  

If the HPV test is positive for high-risk HPV strains, that increases your risk of anal cancer even further. In addition, your doctor may advise you to do an Anal Pap Smear at the same time as this test will show if there are any abnormal cells that may indicate early stage of anal cancer. 

So who are considered at risk of developing anal cancers?

• Individuals who engage in receptive anal sex;
• HIV positive individuals

What is HPV high risk group test?

Rapid HPV Test + Thin Prep test

allows you to identify not just cervical cancer or a pre-cancerous state, but also High-risk HPV infections which may precede cell changes 

What will be done during the anal pap smear test?

The doctor will get you to lie on your side with both your knees slightly bent. He will then insert a cotton stick into the anus and take the sample of the cells from the inside of the anus. 

You may experience a bit of discomfort but it shouldn’t be painful.

How long will the result of the anal pap smear be available?

Typically, it can take 5-7 days for the results to be available.

What if the anal pap smear result shows abnormal results?

Your doctor will discuss with you the significance of the abnormal results and if necessary refer you to do further testing like putting a camera into the anus. 

How can I prevent myself from being infected with the high risk HPV?

You can discuss with your doctor about getting the HPV vaccine like Gardasil 9 to reduce the risk of getting high-risk HPV.

In addition, with Gardasil 9 vaccine you can also reduce the risk of getting genital warts as well.