What matters the most for the prevention of anal cancer are individual risk factors, not legal gender.
Anal cancer is the growth of tumor cells that starts in the anal canal, a short tubular organ at the end of the rectum.
Anal cancers are relatively uncommon. As with cervical and vulvar cancer, many cases are associated with persistent infection with high-risk human papillomavirus (HPV).
HPV vaccination is recommended starting at age 9 to protect against infections that can cause HPV-related cancers cancers later in life. People who were not vaccinated earlier can still receive the vaccine free of charge up to age 30.
The HPV vaccine protects against many, but not all, HPV types that can cause cancer. Unlike cervical cancer, there are no screening tests for anal cancers in people who do not have any signs or symptoms. The pap test does not screen for anal cancers. For this reason, early detection relies on recognising possible symptoms and seeking medical advice promptly.
More information is provided below.
Do I need screening for anal cancer?
Unlike cervical cancer, there are no screening tests for anal cancers in people who do not have any signs or symptoms. The pap test does not screen for anal cancers. Therefore, early detection relies on recognising possible symptoms and changes affecting the anal area, such as persistent itching, pain, sores or ulcers, lumps, skin changes, bleeding or blood in the stool.
If symptoms or suspicious lesions are present, your healthcare provider may recommend further assessment, which may include a physical examination and/or a biopsy, depending on the clinical situation.
Infections and risk of anal cancer
Certain infections and conditions that affect the immune system can increase the risk of anal cancer.
One of the main risk factors is persistent infection with certain high-risk types of human papillomavirus (HPV), a very common virus that can be transmitted through sexual contact.
HPV is so common that more than 80% of sexually active people will acquire an HPV infection at some point in their lives. It can be passed between partners regardless of gender and sexual orientation, including through vaginal, anal, or oral sex, genital skin-to-skin contact, or by sharing sex toys.
In most people, the infection clears on its own. In a small proportion of people, the infection persists and can contribute to the development of anal cancer over many years. People with a weakened immune system, including people living with HIV or those receiving long-term immunosuppressive treatment, are less likely to clear HPV infections naturally. As a result, they have a higher risk of persistent HPV infection and HPV-related cancers, including anal cancer.
The good news is that many HPV-related cancers can be prevented through HPV vaccination.
Important to know:
- Condoms reduce the risk of HPV transmission but do not provide complete protection. This is because HPV is transmitted through intimate skin-to-skin contact, including areas that are not covered by a condom.
- The HPV vaccine protects against many HPV types that can cause anal cancer. However, the vaccination does not cover all HPV types. For this reason, it is important to seek medical advice if you notice any unusual symptoms, even if you have been vaccinated.
Can HPV vaccination help?
HPV vaccination protects against the high-risk HPV types responsible for most cervical cancers and many cancers of the anus, vulva, vagina, penis, and oropharynx (back of the throat, including the base of the tongue and tonsils). It also protects against the low-risk HPV types that cause most genital warts.
Vaccination is recommended from the age of 9 and is most effective before exposure to HPV, although it can still provide benefits later in life. In Belgium, people who were not vaccinated earlier can still receive the vaccine up to age 30.
For more information on HPV vaccination, see the dedicated section.
General Considerations
The information in this website is meant to provide general guidance and education. It cannot replace a medical consultation that takes into account a person’s medical history, risk factors, and preferences.
Whether surveillance or diagnostic testing is appropriate depends on a person's individual risk factors, symptoms and preferences. These tests also have limitations and possible downsides that should be discussed with a healthcare provider.
