- men who have sex with men,
- any patient with a history of anogenital condylomas and,
- women who have a history of abnormal cervical or vulvar cells.
What Are Anal Paps?Most everyone has heard of pap smears. But almost everyone will associate a pap smear with women. A pap smear in women is done by a doctor who uses a plastic applicator or brush to collect a sample of cells from the cervix. These cells are examined under a microscope to identify cell changes that might indicate cancer. An anal pap is very similar. Your doctor swabs the inside of your rectum to obtain a sample of rectal cells. These cells are also examined under a microscope to identify any changes that may indicate the presence of anal cancer. Anal cancers are much more common in men who have sex with men, and in particular those living with HIV than in men or women without HIV. Just as it is important for women to identify cervical cancers early, it is equally important for men to identify anal cancers before they become advanced. The earlier they are identified, the more promising the prognosis. Though comprehensive studies are lacking, it appears that anal paps anal paps provide early detection that may prove to save your life.
What Do The Results Mean?Pap smear results in women are classified according to the type and extent of cellular changes present when examining the cells collected during the cervical swab. While these same classes can be used for grading cells collected during an anal pap, studies have shown that these classes are not good predictors of which men will have high grade cellular lesions indicative of cancer. For that reason it is recommended that anyone with an anal pap result that is anything but normal should be examined using high resolution anoscopy. Anoscopy involves a clear, lighted plastic anoscope being inserted into the rectum. Aided by chemical staining, the areas of cellular changes can be directly examined by the physician using magnification. If necessary a biopsy of the area in question can be done to microscopically diagnosis cancer.
To Summarize - If your anal pap is anything but normal, you will be referred to a specialist to have a high resolution anoscopy.
Source: Panther, L. "Spectrum of Human Papillomavirus-Related Dysplasia and Carcinoma of the Anus in HIV-Infected Patients"; AIDS Read. 2005;15(2):79-91.
Panther, L. "Spectrum of Human Papillomavirus-Related Dysplasia and Carcinoma of the Anus in HIV-Infected Patients"; AIDS Read. 2005;15(2):79-91.