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Preventive/screening for anal cancer
May 4, 2002

Is there any current preventive/screening for Anal cancer such as a PAP smear for cervical CA ? If so can you provide me with details. Thank you very much. Great site !!!!

Response from Dr. Dezube

I recommend an anal PAP smear for all the gay men in my practice whether or not they are HIV positive. An anal PAP smear is a very simple thing to do. A swab is inserted into the butt and rubbed along the wall lining. The cells which go on to the swab are than analyzed under the microscope for early changes of cancer. Anything but a normal PAP smear should then be further evaluated by colposcopy/high resolution anoscopy. This is a procedure by where a provider looks up your butt with a special type of scope to get a good look at the wall of the butt. A provider will often biopsy any suspicious abnormality. If the biopsy shows normal tissue or low grade dysplasia, then nothing more needs to be done other than routine follow-up. If the biopsy shows high grade dysplasia or cancer, then further evaluation and treatment is necessary. I should add that in patients with anal warts, I often recommend that they have high resolution anoscopy no matter what the PAP smear shows. The high resolution anoscopy allows the provider to assess for internal warts and early cancerous changes as above.

HIV positive, how is it possible? Will I be dead by 10 years?
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