We all know that men should routinely examine their scrotums for unusual lumps that could be indicative of testicular cancer. Now, a new study suggests that they could benefit from another sort of self-examination, as well.
Anal cancer rates are higher amongst gay men than their straight counterparts. This is largely due to queer men being more likely to develop anal warts (caused by the HPV virus) earlier in life. They’re a known risk factor for this particular cancer. Being HIV+ and smoking are further risk factors.
Researchers now suggest gay men be encouraged to examine their anuses with a finger to check for any lumps or lesions.
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The scientists, based in Wisconsin, Chicago and Houston, wanted to see if a group of higher-risk of anal cancer might benefit from self-examining themselves.
The Prevent Anal Cancer Palpation study enrolled 714 gay and bisexual men and transgender women in Houston and Chicago between 2020 and 2022. Results appeared recently in The Lancet.
Skin tags and hemorrhoids
The participants were given 15 minutes of guidance on how to self-examine themselves around the anal region. This included within the anal canal, up to the second joint of their index finger.
Some couples were also involved in the study and they were shown how to examine each other.
Most anal cancers are not detected until tumorous lumps have reached an average size of 3 cm or more. This can result in more invasive treatment. The earlier a cancerous lump is detected, the better.
Researchers wanted to know: Would people self-examining themselves help to find small abnormalities?
In the study, a clinician first examined the participants and noted any possible lumps. The participants then self-examined and reported if they came across the lumps.
Abnormalities were found in 34% of participants. These were mainly hemorrhoids and skin tags (around 90% of all the lumps detected). Around a dozen people had a “suspicious lump or thickening” that presumably warranted monitoring or further investigation.
In 59% of cases, when a clinician identified an abnormality, the patient was also able to detect the same abnormality through self-examination. That’s enough for the researchers to say that those at a heightened risk of anal cancer should be encouraged to check themselves for lumps.
Regular smear tests and exams
Of course, self-examination is not a substitute for a full and proper medical examination by a professional. Some physicians suggest an annual examination for HIV-positive men and every 2-3 years for those who are HIV-negative after the age of 50, but opinions differ.
However, anal cancer screening is not widespread or routine. Some men are shy or embarrassed about seeking medical help for such matters. And too often, people only seek help when they suspect something is seriously amiss.
If those at more risk could examine themselves occasionally, and seek help sooner if they come across something suspicious, cancers can be caught earlier. Treatment is often 100% successful if tumors are caught when they’re less than 1 cm in size.
In this study, 90% said they found self-examining “easy”. Nine percent said it was “hard or very hard”. This could be related to their weight and size.
“These results suggest that [anal self-examination] may detect early-stage anal cancer when treatment is more successful,” concluded the authors. “When discussing anal cancer screening with patients, clinicians may advise that self- and partner examination of the anal region may result in detection of invasive tumours when they are smaller and easier to treat, although it is not a substitute for a clinician’s [full examination].”
What is anal cancer?
As its name implies, it’s cancer of your anus.
The majority of anal cancers are linked to human papillomavirus (HPV) infection. HPV is also linked to cancers of the cervix, penis, and throat.
Each year, around 14,000 men in the U.S. get HPV-associated cancers. The majority of these are throat-related (over 11,000), with anal cancer accounting for around 2,000 cases.
Compared to other cancers, anal cancer is rare. However, HPV infection is very common. In the U.S., it’s estimated that around 80 million adults are infected with HPV, and many will never know they have it.
Experts recommend HPV vaccination for many young people. In the U.K., gay men under the age of 45 are offered the vaccine free in sexual health clinics, whereas girls are jabbed while still in school. In the U.S., HPV vaccination policies differ from state to state.
Related*
HIV and anal cancer: The good and bad news for gay men
Have you thought about getting screened for anal cancer?
Why some gay men are getting this test to detect the early signs of a specific cancer
Let’s talk pap smears!
