Do You Need An Anal Pap Smear?

Believe it or not, anal pap smears are not as common as they should be. At Bespoke Surgical, Dr. Goldstein has been at the forefront of educating people about what they are, who should get them, why you should get them, and how often you should get them. Everyone, especially those who engage in anal sex and rimming, should educate themselves about HPV and anal cancers and that’s exactly what you‘ll be able to do on this page.

What Is An Anal Pap Smear?

An anal pap smear is effective to detect cancer at an early stage, helping people catch it while the cancer is still treatable. It works by sampling cells in the rectum and anus. Just like cervical pap smears, anal pap tests are a good idea for those at high risk for anal cancer, including those who engage in anal sex and rimming.

According to Cancer.Org, human papillovirus (HPV) is currently thought to be linked to the majority of anal cancers. People who have had or currently have HPV are at a higher risk for anal cancer. Need a refresher on HPV? Learn about HPV and anal warts here.

While this could be called a pap smear for men, women can benefit from this too

Why Ask For An Anal Pap Smear?

Anal cancer rates have been on the rise in the United States. According to a study by the Journal of the National Cancer Institute, the overall incidence of anal cancer increased by 2.7% per year and mortality jumped by 3.1% each year between 2001-2015.

That‘s why catching cancer before it happens – in the precancerous stages – is the most effective way to prevent the problem. Being proactive by engaging in male pap smear tests or a rectal pap test is a great way to make sure your anal health stays strong. Patients with risk factors for anal cancer should ask their doctors about the anal pap smear procedure to find out if it’s a good match for them. Doctors should encourage, at a minimum, annual anal pap smears to patients who may be at a higher risk.

How Does A Rectal Pap Smear Work?

Anal pap smears can be uncomfortable, no doubt, but the good news is that they are generally very quick and painless (if they‘re done right). The key is finding a doctor who not only performs them for you, but uses the correct swab. Oftentimes, doctors request the patient perform a rectal pap smear on themselves, which introduces plenty of room for error and, consequently, misdiagnosis. In the procedure, your provider will insert a swab that looks like a long Q-tip into your anus. If they are using something that resembles (both in look and feel) a pipe cleaner, stop and ask for a Q-tip swab. If they don‘t offer this, find someone who does. Typically, the swab will only go 2-3 inches inside the anus in order to swab all of the surfaces and collect a thorough sampling of cells.

Two swabs are usually done, especially during the first evaluation. One swab will test which types of HPV the patient has, low risk and high, and then the second swab will look at the anal cells to see if there are any cell changes. If someone has high-risk HPV, Bespoke Surgical is the only practice performing a special staining and test, called the terc-Fish test, that actually looks at the DNA. All of us, for the most part, have HPV on the cell surface and that‘s what everyone tests for. But we at Bespoke Surgical actually want to know if the DNA has been altered because anal pap smear tests can produce many false positives and this often leads us down an unnecessary pathway to biopsying and other diagnostics. The benefit of the terc-Fish test is being able to tell us whether or not the DNA is altered and truly helps us determine the most appropriate next steps.

Depending on the provider, after the male pap smear test the doctor may also do a brief rectal exam to check for abnormalities. Overall, male pap smear procedure works similarly to the cervical smear test. While no one loves the process, it‘s an extremely helpful procedure to ensure your health is at its best.

Once the rectal pap test is done, your healthcare provider will send the sample to a lab. The pathologists and technicians at the lab will determine if the sampled cells are normal, precancerous (dysplastic) or cancerous. Some providers will also check for HPV during this process.

If your anal pap test comes back with abnormalities, you may be asked to come in for further testing. Check out our Anal Pap Smear page to learn more.

Before Your Anal Pap Smear

Before you go in for your anal pap smear, there are a few things you should be aware of to prepare yourself for your test. It‘s helpful to avoid inserting anything into the anus for 24 hours prior to the procedure. This includes lubricants, medications or other creams. It‘s also recommended that you avoid douching or using enemas to clean out the rectum before an anal pap smear because it affects the pathologist‘s read on your results.

If you are unable to adhere to these precautions, it‘s always a good idea to call your provider and ask if your test should be rescheduled.

Tips For Finding Healthcare Providers For Male Pap Smear Tests

As mentioned before, it‘s important for anal pap smear patients to find an appropriate healthcare provider who can properly administer an anal pap smear test because not every practice will be familiar with anal pap tests.

The best place to start is to ask your primary provider to help you find a local provider or clinic that offers anal pap tests. Alternatively, clinics that provide care for patients with HIV or organ transplant patients are great resources for rectal pap tests. We recommend looking for a LGBTQ+ friendly clinic or STD screening location to find knowledgeable care that handles HPV and HIV regularly.

If you live near New York City, Bespoke Surgical is an elite anal surgery practice with a focus on wellness. Contact us today to schedule your anal pap smear appointment.

Who Should Get An Anal Pap Test?

While there are no national organizations that recommend routine anal cancer screenings, some providers offer specific guidelines depending on risk factors.

Here at Bespoke Surgical, we recommend anal pap tests be added to your regular screening protocol. Many people may be at risk from a variety of factors, including anal play or medical history. Risk factors include:

• Smoking
• Having anal warts
• Engaging in anal intercourse
• Having human papillomavirus (HPV)
• Being diagnosed with HIV, particularly if you have genital warts
• People who are immunosuppressed or have had organ transplants
• Having a history of anal or cervical dysplasia
• Anyone who has had a historical of abnormal cervical pap results

Anal intercourse is also a risk factor for other health conditions when not practiced safely. Check out our blog Can Anal Sex Cause Prostatitus to read more about best practices to enjoy your time in the bedroom while staying healthy.

Can I Manage My Risk Factors?

Besides regular anal pap tests, there are other things you can do to help lower your anal cancer risk. Some tips that can help include:

• Getting the HPV vaccine, which is highly effective at preventing HPV warts and HPV-related cancers
• Practicing safe anal sex by using condoms, and getting regular STD tests with your partners
• Quitting smoking, as smoking lowers the body‘s natural immunity
• Treating HIV if you have a diagnosis

Did you miss the HPV vaccine window before age 25? As of 2018, Gardasil for HPV prevention has been expanded to ages 27-45. Consider reading our blog post about HPV vaccine age expansion to see why this is so monumental.

The Bottom Line

Especially for patients with multiple risk factors, it‘s important to stay on top of your health. And this includes screenings for HPV and anal cancers. At Bespoke Surgical, we‘re happy to answer any questions and provide any information you might need to determine if you should get an anal pap smear. Contact us today if you‘d like to talk more about your risk factors or become a patient.