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should family members be screened for anal cancer as well?
Oct 10, 2002

My brother has been diagnosed with anal squamous cell cancer - does this automatically mean, as my own GP suggested, that I should be screened for rectal cancer as well or because this is an HIV related cancer, I do not need to have regular screening if there is no symptoms indicating that I have a problem.

Response from Dr. Dezube

First we need to differentiate between rectal cancer and anal cancer. They are actually quite different. Anal cancer comes from the anal canal, which is the portion of the gut closest to the butt-hole. On the other hand rectal cancer comes from the rectum, which is higher up in the gut; the rectum is responsible for storing a bowel movement until one reaches the bath room.

Anal cancer is most oftenly caused by the human papilloma virus (HPV, also known as the wart virus). For the most part it is NOT related to one's genes, so there is NO reason for the family members to be screened. On the other hand, rectal cancer does tend to run in families. If you have a relative with rectal cancer, then depending on the circumstances, you are two or more times likely to get rectal cancer.

Lastly, screening for colorectal cancer is a good idea for everyone regardless of status of family members. Typically a digital rectal exam is done by a medical provider. By doing this, the provider checks the patient's bowel movement for the presence of blood. Blood in the bowels needs to be evaluated. Such a procedure also allows the provider to check out a guy's prostrate. At what age should this be done? Many feel that yearly rectal exams starting at age 40 is reasonable. Some providers and organizations recommend colonoscopy every 10 years for patients over the age of 50.


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