When I tell my male patients they’ll be having a pap smear, they often think I am joking. But, anal pap smears and anal cancer are no laughing matter. While anal cancer is quite uncommon, the risk for men who have sex with men (MSM) is much higher. There are over 200 strains of HPV but two strains in particular, HPV-16 & HPV-18, cause the majority of HPV-related cancers.
We have grown accustomed to women going in for their routine pap smears, but the thought of men having pap smears has not really caught on Yet, the same virus (HPV) that causes cervical cancer in women is responsible for causing anal cancer in men. The fact is that gay and bisexual men are at a much higher risk of anal HPV, which puts them at an increased risk for anal cancer. The risk is even higher in HIV positive gay and bisexual men. When compared to the general population, some figures have put the risk for anal cancer at 35 times greater for HIV negative MSM and 80 times greater for HIV positive MSM.
So, what is the good news? Well, anal cancer is both preventable and treatable if caught early. This is where anal pap smears come in. Pap smears of the anus and rectum can detect abnormal cells that are can be a precursor to cancer. If your anal pap smear indicates you have abnormal cell growth, we recommend having a High-Resolution anoscopy (HRA) to further determine the level of the abnormal cell growth.
We perform both anal pap smears AND HRAs at our office in Atlanta. During an HRA, a biopsy can be performed to help us decide on how to treat or monitor the abnormal cells. In many cases, your body’s own immune system will help clear the infection, but in some people, the HPV will cause cellular changes that eventually lead to anal or rectal cancer. This is why having a provider who understands this and is able to monitor it is important.
What is an Anal Pap Smear?
“What exactly is an anal pap smear?” is a common question I hear often. An anal pap smear involves taking a q-tip and swabbing the inside of the anus and rectum in order to gather cells in that area. This sample is then sent to the lab where it is examined under a microscope for abnormal cells. The results will let us know if you have any abnormal cells, and if so, what just how abnormal they are, which will guide how we proceed with monitoring and treating the condition.
In regards to anal cancer, prevention and detection is key! So, if you are a gay or bisexual man, ask about getting an anal pap smear the next time you’re at your doctor’s office.