Anal Pap Smear

What is anal cancer?

Anal cancer refers to abnormal cell growth either inside or around the anal opening. This condition can affect both genders and tend to be more prevalent among those aged between 55 and 64.

Anal cancer is one of the least common types of cancer, accounting for only 1-2% of intestinal cancers. However, because of the increasing cases of HIV and HPV, the incidence rate of anal cancer has also increased significantly in the last few years.

What symptoms are associated with anal cancer?

In its earliest stage, anal cancer often doesn’t show any visible symptoms. However, later stages as generally accompanied symptoms such as:

  • Anal ulcers
  • A sensation of fullness or pain in the rectum
  • Itching, pain as well as general discomfort around the anus
  • Fecal incontinence
  • A lump near the edge of the anus
  • Presence of blood or mucus in your stool

Who is at risk for anal cancer?

Factors that increase your risk of anal cancer include;

  • HPV
  • Smoking
  • Compromised immune system from either chemotherapy or HPV
  • STDs
  • Anal sex
  • Being older than 55
  • Multiple sex partners
  • History of HPV-related cancers such as cervical cancer
  • Chronically inflamed areas around your anus
  • History of pelvic radiation therapy for bladder, prostate, cervical, or rectal cancer.

Note: While only a small number of anal cancer cases spread, they usually spread to the lungs and liver, making them quite tough to treat. Early diagnosis through an anal pap smear is key to surviving anal cancer.

What is an anal pap smear?

Also referred to as anal cytology, an anal Pap smear is a screening test for anal cancer. This test involves extracting a cell sample from the anal canal to test for anal cancer.

What can I expect during an anal pap smear?

An anal pap smear is generally a very straightforward medical exam.

  1. Your doctor will insert a small swab inside your anal region to extract a sample of cells.
  2. After the swab, your doctor will also perform a general rectal exam using his finger to check for any abnormalities such as enlarged glands, bleeding, or swelling.
  3. Your anal sample will thereafter be sent to the lab, where it will be examined under a microscope.
  4. Your results will show if there are any visible signs of cancer or precancer.
  5. Note: Your doctor may check for HPV itself.

Is an anal pap smear painful?

While the procedure is generally not painful, as it involves the insertion of a swab inside your anal region, you may experience slight discomfort.

You are strongly advised not to insert any object into your anal region for 24 hours before the procedure. Anal Pap Smear may be conducted yearly depending on an individual’s risk for anal cancer.

How can I prepare myself for an Anal Pap Smear?

It is highly recommended that you refrain from using either any creams or cells before you undergo the test. Failure to do so may affect the quality of the cell sample.

Should your doctor establish that indeed you have anal cancer, they will carry out imaging or ultrasound tests such as MRI to determine the severity of cancer.

Who is eligible for an Anal Pap Smear?

You are strongly encouraged to consider an Anal Pap Smear if you have:

  • HIV
  • HPV
  • Hepatitis B
  • Are a smoker
  • Engage in anal sex
  • A history of vulvar, vaginal or cervical cancer
  • A history of genital warts
  • Undergone organ transplant

Note: Research has shown that the use of antiretroviral drugs among HIV patients may help minimize the risk of anal cancer.

How is anal cancer treated in Singapore?

In general, there are three distinct types of anal cancer treatment options, including;

  • Surgery
  • Radiation therapy
  • Chemotherapy

Usually, a combination of therapy and radiation is the standard anal cancer treatment. Surgery is only considered if either the cancer is advanced or the cancer is in the earliest stage.

Thankfully, a significant number of anal cancer cases are usually detected early enough, especially if the cancer is located in an area where your doctor can easily touch or spot it. If your risk of developing anal cancer is fairly high, you should consider including an anal pap smear in your routine and yearly health screening.


Can Anal Pap Smear be used to detect other conditions apart from anal cancer?
Is there any downtime associated with the procedure?
How soon can I get my Anal Pap Smear results?
Can Anal Pap Smear detect HPV?

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