About 10,540 people are diagnosed with anal cancer each year in the U.S. Approximately 90% of cases are caused by HPV — and many are preventable. Yet stigma and lack of awareness keep people from getting screened. That changes here.
Colorectal cancer and anal cancer are often grouped together, but they have different causes, risk factors, and screening methods. Here's what sets them apart.
Unlike colorectal cancer screening (which starts at 45 for everyone), anal cancer screening is recommended for people at higher risk. The 2024 IANS Consensus Guidelines identify two categories.
Higher incidence warrants direct screening
Shared decision-making recommended
What does “shared decision-making” mean? You and your doctor discuss whether screening makes sense based on your individual risk factors, health history, and preferences.
If you or your provider decide screening is right for you, these are the methods available. All are done in-office and can catch problems early.
A quick physical exam where a provider checks the anal canal for lumps or abnormalities. No prep needed — it takes just a few minutes during a regular visit.
Like a cervical Pap smear, this test collects cells from the anal canal to check for abnormal changes. Quick, in-office, and can catch precancerous cells early.
A specialized procedure that lets providers directly examine and treat precancerous lesions. Usually a follow-up if Pap results are abnormal. The ANCHOR study proved this approach works.
Many of these symptoms can have other explanations — but they always deserve medical attention. If anything persists for more than a few weeks, talk to your doctor.
Bright red or dark blood when you go to the bathroom. This is never normal and always worth mentioning to your doctor.
A noticeable lump or growth near the opening of the anus that may be tender or painless.
Persistent pain or a sense of fullness in the anal area. Not something to brush off as hemorrhoids without evaluation.
Unusual discharge, mucus, or persistent itching in the anal area that doesn't resolve.
Persistent changes in stool consistency, narrowing of stools, or a feeling that the bowel doesn't empty completely.
Losing weight without trying or feeling unusually tired, especially combined with other symptoms.
These symptoms don't always mean cancer — but they always mean you should talk to your doctor.
Find a screening provider near youHPV causes about 90% of anal cancers. Getting vaccinated — ideally before exposure — can dramatically reduce your risk. Here's what you need to know.
Human papillomavirus is the most common sexually transmitted infection. Most people clear it naturally, but persistent infection with high-risk types (especially HPV16 and HPV18) can lead to anal cancer over time.
HPV myths vs. facts →The HPV vaccine is recommended through age 26 for everyone. It's available up to age 45 through shared clinical decision-making. Even if you've had HPV, vaccination may protect against strains you haven't encountered.
This landmark clinical trial proved that treating high-grade precancerous lesions (HSIL) in people living with HIV reduced anal cancer by 57%. It's the strongest evidence yet that screening and early treatment work.
Protect yourself and your community.
The right time to begin anal cancer screening depends on your risk factors. The 2024 IANS guidelines set clear starting ages for different groups.
For the highest-risk groups
People in these groups face the highest incidence of anal cancer and benefit most from early, regular screening:
What to ask for: Regular screening with DARE and anal Pap test, with HRA referral if abnormalities are found.
See screening methods →For broader at-risk groups
A wider group of people should discuss screening with their provider at age 45, including:
For Category B groups, screening is a shared decision with your doctor based on your individual risk.
Provider screening guidance →The biggest risk factor is persistent HPV infection, especially in the context of a weakened immune system. Other factors include:
The good news: HPV vaccination, regular screening, and treatment of precancerous lesions can all significantly reduce your risk.
A cancer diagnosis can feel overwhelming. Here's an overview of what to expect — and remember, you don't have to navigate this alone.
Learn what tests and exams are used to diagnose anal cancer and what to expect.
Learn MoreCancer staging helps determine treatment options. Learn what each stage means.
Learn MoreCommon treatments include radiation, chemotherapy, and sometimes surgery. Learn about your options.
Learn MoreWork with your care team to develop a personalized plan. Know what questions to ask.
Learn MoreTreatment for anal cancer can cause physical and emotional side effects. Understanding what to expect helps you prepare and cope.
Life after treatment brings its own challenges and milestones. From follow-up care to rebuilding your daily life, there's support available.
Providers play a critical role in identifying patients at risk for anal cancer and offering appropriate screening.
Assess patients for anal cancer risk factors, including HIV status, sexual history, HPV history, and immunocompromised status.
Offer DARE (Digital Anal Rectal Exam) as a simple first-line screening during routine visits for at-risk patients.
Consider anal Pap testing for high-risk patients. Refer for HRA if abnormalities are found.
Discuss HPV vaccination with eligible patients up to age 45, regardless of sexual orientation.
ANCHOR Study: The landmark study demonstrating a 57% reduction in anal cancer through treatment of precancerous lesions in people living with HIV.
HPV Cancers Alliance: ANCHOR Study →HIV Clinical Guidelines: Comprehensive protocols for anal cancer screening in adults with HIV.
HIV & Anal Cancer Guidelines →Butts & Badges: Get your clinic involved in cancer awareness.
Join Butts & Badges →Provider Toolkit: Download screening resources and guides.
Provider Resource Toolkit →Complete resource on risk factors, HPV, screening, treatment, and LGBTQ+-affirming survivorship care.
Virtual bi-monthly support groups for LGBTQ+ individuals affected by colorectal and anal cancers.
Emotional wellness support for patients, survivors, and caregivers navigating a cancer journey.
A stigma-free guide to understanding and caring for your butt health.
Resources on HPV-related cancers, including anal cancer, and information about the ANCHOR study findings.
Research-backed anal cancer information including treatment options, screening studies, and clinical trial access.
Clinical guidelines for screening and treatment of anal dysplasia and cancer in adults with HIV.
Cancer prevention and early detection resources, including LGBTQ+ specific screening guidance.
Also concerned about colorectal cancer?
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Full Anal Cancer Guide