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Anal Cancer
Reviewed by Medicinsk Expert•Last updated: 2026-10-22•Digestive System

Anal Cancer

Anal cancer is a malignancy of the anus often linked to high‑risk HPV infection, with identifiable risk factors, symptoms, and treatment options.

Overview

What is anal cancer?

Your anus is the opening at the end of your large intestine. It is where stool (poop) leaves your body. The anus is formed partly from your outer layers of skin and partly from your intestine. Anal cancer is a type of cancer that forms in the tissues of your anus.

Causes & Risk Factors

Who is more likely to develop anal cancer?

Anyone can get anal cancer, but you are more likely to develop it if you:

  • You have an infection with high‑risk HPV, especially if you have certain types. Most anal cancers are related to HPV infection.
  • Have a weakened immune system, from conditions such as HIV or because of medicines you need to take after an organ transplant.
  • Have had vulvar, vaginal, or cervical cancer.
  • Have many sexual partners.
  • Have anal sex.
  • Smoke cigarettes.

Symptoms

What are the symptoms of anal cancer?

The signs and symptoms of anal cancer may include:

  • Bleeding from the anus or rectum
  • A lump near the anus
  • Pain or pressure in the area around the anus
  • Itching or discharge from the anus
  • A change in bowel habits, such as narrower stools, having to go more often, or bowel incontinence

Diagnosis

How is anal cancer diagnosed?

To find out if you have anal cancer, your provider:

  • Will take your medical history, which includes asking about your symptoms.
  • Will ask about your family health history.
  • May do a digital rectal examination (DRE). A DRE is an exam of the anus and rectum. For the exam, your provider will insert a lubricated, gloved finger into the lower part of your rectum to feel for lumps or anything else that seems unusual.
  • May order tests that examine the anus and rectum, such as:
    • An anoscopy, an exam of the anus and lower rectum using a short, lighted tube called an anoscope. There is also a type of anoscopy called a high‑resolution anoscopy. It uses a special magnifying device called a colposcope along with the anoscope to view these areas.
    • A proctoscopy, a procedure to look inside the rectum and anus using a thin, tube‑like instrument with a light and a lens.
    • An endo‑anal or endorectal ultrasound, a procedure in which an ultrasound probe is inserted into the rectum.
  • May do a biopsy during an anoscopy or proctoscopy.

Treatment & Management

What are the treatments for anal cancer?

The treatments for anal cancer include radiation therapy, chemotherapy, and surgery. Which treatment you get will depend on how advanced the cancer is, your overall health, and your preferences.

Prevention

Can anal cancer be prevented?

You may be able to lower your risk of getting anal cancer by getting an HPV vaccine and not smoking. Contact your provider if you need help quitting smoking.

It is currently not known if using condoms can prevent anal HPV infections. But using latex condoms every time you have sex can help prevent HIV, a risk factor for anal cancer. And they also help prevent other sexually transmitted infections (STIs). If you or your partner is allergic to latex, you can use polyurethane condoms.

If you are an adult with HIV, it's important to get an anal cancer screening every year. The screening checks for anything that seems unusual, such as lumps, burning, and precancer cells (cells that could turn into cancer). The screening will include a digital rectal exam. If anything unusual is found, you will have an anoscopy or high resolution anoscopy.

Frequently Asked Questions

digital rectal exam involves a provider inserting a gloved, lubricated finger into the rectum to feel for lumps or abnormalities, which is a quick screening tool. Anoscopy involves using a small, lighted tube to visually inspect the anal canal and lower rectum. Anoscopy is generally more sensitive for detecting small lesions, polyps, or early-stage cancers that might be missed by touch alone, and it is often performed if the DRE is abnormal or if symptoms persist.
The HPV vaccine works by training your immune system to recognize and fight specific high-risk strains of the human papillomavirus before they can cause cellular changes. It is most effective when administered before sexual debut, but it can still offer protection against strains you have not yet encountered. If you have already been infected with a specific strain, the vaccine will not treat that existing infection, but it can prevent infection from other high-risk types included in the vaccine.
Sexual activity may be possible during treatment, but it depends on the type of therapy and your physical comfort. Radiation and chemotherapy can cause fatigue, skin irritation, or changes in sensation. It is crucial to use barrier methods like condoms or dental dams to prevent the transmission of HPV to partners, as the virus can be shed even if you do not have visible symptoms. Discuss any concerns about pain or discomfort with your oncology team to ensure safe and comfortable intimacy.
Long-term side effects of radiation can include changes in bowel habits, such as increased frequency, urgency, or incontinence, as well as vaginal dryness in women or erectile dysfunction in men. These effects are often manageable with pelvic floor physical therapy, dietary adjustments to reduce stool bulk, and topical treatments for dryness. Regular follow-up with your healthcare provider is essential to monitor for late-onset complications and to implement supportive care strategies that maintain your quality of life.
Source: MedlinePlus, National Library of Medicine

MedlinePlus brings together authoritative health information from the National Library of Medicine (NLM), the National Institutes of Health (NIH), and other government agencies and health-related organizations.

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