Anal Cancer Awareness Day - Callen-Lorde

Anal Cancer Awareness Day

March 21st is Anal Cancer Awareness Day – a cancer that is relatively rare in the general population but is unfortunately much more common with people who live with HIV. Due to discrimination and stigma, there is a greater possibility that people at increased risk may neglect care.  

Anal cancer is a disease that is almost exclusively caused by a virus called HPV (the Human Papillomavirus). Most sexually active adults have at least one strain of HPV and for many people, it causes no significant health issues. However, certain strains of HPV have the potential to cause changes in the skin in a variety of vulnerable locations, including the anal canal. These changes are not uncommon and are usually taken care of by a person’s immune system on their own.  In some people, however, these changes can continue unchecked – leading to abnormal growth past the skin causing cancer – which happens at significantly higher rates for at-risk populations. 

 All people living with HIV have a somewhat increased risk for the development of anal cancer, but it especially impacts those who were male-assigned at birth and have a history of male-assigned at birth sexual partners. People living with HIV, with a history of vulvar cancer or vulvar pre-cancer are also at increased risk for anal cancer. Other risk factors include increasing age, smoking, and the number of lifetime partners for receptive anal sex (bottoming). 

Symptoms of anal cancer can include pain with bowel movements, bleeding from the anus or rectum, a mass or growth in the anal canal, anal itching or pain with anal sex. If you are at risk of anal cancer or have experienced any of the listed symptoms, talk to your medical provider. At a minimum, anyone with increased risk should have an annual Digital Anal-Rectal Exam (DARE). 

At Callen-Lorde, we have offered comprehensive anal cancer prevention care for more than a decade. This includes a DARE and anal cytology (“pap smears”) for folks at increased risk. If that screening test is abnormal in any way, people are referred to our High Resolution Anoscopy (HRA) program. HRA is the technique we use to identify lesions, biopsy them to confirm the presence of pre-cancerous cells and guide treatment. We now have published data from the ANCHOR study which showed that treatment of pre-cancerous lesions significantly reduces the risk of progression to anal Cancer among people living with HIV.