Published on May. 29, 2026
Some medical conversations are awkward, and anal cancer screening is one of them. But according to Ketan Thanki, M.D., colorectal surgeon at MemorialCare Todd Cancer Institute at Long Beach Medical Center, the potential discomfort of having this conversation is nothing compared to the consequences of avoiding it. Below, he answers common questions about who should be screened, what the test involves and why early detection matters.
Yes. Anal cancer is still rare, but rates have risen by about 10% each decade. One reason is that most cases are linked to HPV, or human papillomavirus, with about 90% tied to cancer-causing strains. Even with that increase, anal cancer is largely preventable and highly treatable when caught early.
People at higher risk should ask their doctor about screening. That includes people living with HIV, men who have sex with men regardless of HIV status, women with a history of cervical or vulvar dysplasia, organ transplant recipients on immunosuppression, and anyone with a history of anal warts.
If you are not sure whether you are at higher risk, talk to your doctor about whether screening makes sense for you, especially if you think you have HPV or related risk factors.
The most widely used screening tool is an anal Pap smear, which works much like a cervical Pap smear. A swab collects cells from inside the anal canal to check for abnormalities or HPV. The test takes about 10 seconds and can be done during a regular office visit with your physician. To help patients feel more comfortable, I will explain each step before the exam begins -- so there are no surprises.
Yes. Gardasil is now recommended for adults up to age 45. Even if someone has been exposed to some strains of HPV, they likely have not encountered all nine covered by the vaccine. It is almost never too late to experience a benefit from getting the Gardasil vaccine.
Early detection can make treatment much simpler. Early-stage anal cancers can often be removed with a local procedure. Cancers that are more advanced but still contained in the anal canal often respond well to chemotherapy and radiation and rarely require surgery. Once the cancer spreads further, major surgery, including the possibility of a permanent colostomy bag, becomes a more serious concern.
If you think you may be at risk, speak with your doctor sooner rather than later. For more information or to schedule an appointment, visit memorialcare.org/cancer or call (562) 933-1877.