Like many forms of cancer, early detection is key to effectively treating anal cancer. Specialists with the Digestive Health Institute High-Risk Anoscopy and Comprehensive Anal Dysplasia Evaluation and Treatment (CADET) Program use advanced technology provide specialized care and advanced monitoring to look for a condition called anal dysplasia that can develop into anal cancer if not treated.
Anal dysplasia relates to changes in the anal cancer that is almost always attributed to the human papillomavirus (HPV). While the overall risk of anal cancer is low for most people, we know certain groups are at higher risk. Research shows that treating anal dysplasia can prevent anal cancer from developing.
Who is at risk?
- People living with HIV
- Men who have sex with men or transgender women
- Women with a history of other HPV-related cancers
- Women who have had persistent, high-risk HPV show on a pap smear for more than a year
- Anyone who has had an organ transplant
- Anyone with a history of anal warts
- People on chronic immunosuppression therapy for conditions like rheumatoid arthritis, lupus, Crohn’s disease and ulcerative colitis
Symptoms and diagnosis
Most people with anal dysplasia have no symptoms, which is why screening is so important. Talk to your provider if you notice:
- Anal or rectal pain
- New lumps or changes to any lumps in the area
- Bleeding from your rectum
- Persistent anal itching
To diagnose anal dysplasia, we use several approaches:
- Digital anorectal exam. The specialist inserts a finger into the anus to feel for abnormalities.
- Anoscopy. A small scope is inserted into the anal canal to give the specialist a better look at the area.
- Anal pap smear screening. Similar to a cervical pap smear, a small swab inserted into the anal canal collects cells to be examined under a microscope for evidence of high-risk HPV.
It’s important to note that colonoscopy does not usually detect anal dysplasia. That screening test looks for polyps linked to colon cancer, which is very different than anal cancer.
Treatment
We know treating anal dysplasia early can keep it from progressing to anal cancer. If ag reveal your risk an anal pap smear shows high-risk HPV or abnormal cells, we will recommend further examination using high-resolution anoscopy (HRA) technology.
For this procedure, the specialist insert a small scope into the anal canal. A special stain helps highlight any abnormal areas. Samples of those tissues can be taken to look at under a microscope and determine if there are pre-cancerous cells present and, if so, how abnormal they are. If abnormal cells are found, we can treat them with targeted ablation or by burning them off.