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rectal exams necessary

Aug 21, 2005

I have been going to the same doctor since 1996 for my HIV care. During that time I have never had a rectal exam. Not that I really want one, but shouldn't that be part of my routine check up--just like my lab work. I do have a history of prostate cancer in my family, which my doctor knows about, so I am a little bit concerned about that. Plus I know HIVers are more at risk for other types of anal/rectal cancers. Is all of this something my doctor is monitoring via my labwork or should I request a regular rectal check up as well. Thanks for your time.

Response from Dr. Holodniy

You don't indicate your age, or if you have any urination or defecation symptoms or problems (prior urine infections, sexually transmitted diseases, bloody stool, etc). You also don't indicate whether you have had anal receptive sex. That said much of the visits to a primary care or HIV clinician are symptom or history driven. Thus, no problems, no exam. Unless it is the first visit (and age appropriate) or there is a significant family history, or you reach a certain age (usually around 50) when a rectal exam for prostate problems or a screening colonoscopy for colon cancer is usually performed. Many men and women may get rectal pap smears if they have had anal receptive sex. If that is negative, it probably won't be repeated for a while unless there is repeated exposure. If the results are abnormal then depending on what is found other things may be done.

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