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Ask the Experts about AIDS-Related Cancers

 

Do I need anal pap smear?
Jun 9, 2003

I had receptive anal sex for once or twice about 12 years ago and never have it again ever since. Now, I am concerned about HPV infection and possible anal cancer.

Do I need to do an anal pap smear? Where can I get one done? I am living in San Francisco bay area. I know that it is not standard yet.

Response from Dr. Dezube

An anal PAP smear is analogous to the cervical PAP smear. With an anal PAP smear, a health care provider inserts a swab and takes a sample from the lining of your anal canal. The cells are then examined for early signs of cancer. Although it is unlikely that you have active HPV disease, you can not say for certain that you did not pick up the disease during your "one or two encounters". Sooooooo, I would indeed recommend that you have an anal PAP smear. If the PAP smear is completely normal, then you do not need to pursue testing further. If the PAP smear is abnormal, then the next stop would be anoscopy, a procedure by which a health care provider looks up your butt to see if anything up there doesn't belong. Usually at the time of anoscopy biopsies are taken. Although I usually do not recommend specific providers, you need to know that the concept of anal PAP smears originated in San Francisco by Dr. Joel Palefsky and associates. That's whom you may want to consult.



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