It can be difficult to talk about diseases that hit "below the belt," but understanding anal cancer and colorectal cancer—two different diseases—can help you take steps to protect your health. Here’s what you need to know.

Incidence of anal cancer rising

Anal cancer is relatively uncommon, but it’s on the rise. Steven Nurkin, MD, MS, a Surgical Oncologist at Roswell Park Cancer Institute (RPCI), says anal cancer has been linked to the human papillomavirus (HPV), a sexually transmitted disease so common that “nearly all sexually active men and women get it at some point in their lives,” according to the Centers for Disease Control and Prevention.

Fortunately, a pap smear—a simple screening procedure widely used to screen women for cervical cancer, which is also caused by HPV—is now being used to screen high-risk men and women for anal cancer. “Forty years of cervical pap smears have reduced the rate of cervical cancer in this country by 500 percent,” notes Dr. Nurkin. It’s hoped that the same technique will reduce the rate of anal cancer.

The anal pap smear involves collecting cells from the anus with a small swab and examining them under a microscope. If they are abnormal, your doctor may recommend high-resolution anoscopy (HRA), a procedure to examine the lining of the anus with a microscope. If abnormalities or precancerous (dysplastic) cells are detected, they are biopsied and often treated before they can become cancerous. If cancer has already developed, early detection should catch it in its earliest, most treatable stages.

RPCI offers anal cancer screening for those at high risk, including people with immune-deficient status, including those with human immunodeficiency virus (HIV);gay and bisexual men; and women who have had HPV-related disease in the past, such as cancer or dysplasia of the cervix or vulva.

Colonoscopy: A chance to prevent cancer?

Unlike anal cancer, colorectal cancer is fairly common, affecting about one in 11 people, and is the second leading cause of cancer death in the United States.

Colorectal cancer has a different set of risk factors: it’s linked to age (most colon cancer patients are over 50), smoking, heavy alcohol consumption, a diet high in fats and red meat, obesity, and family history of colorectal cancer or related medical conditions.

When it comes to colorectal cancer, “any screening test is better than none, but colonoscopy is best,” says Dr. Nurkin.

During a colonoscopy, the doctor examines the inside of the colon using a flexible tube fitted with a light and special camera. If the doctor discovers any polyps (abnormal growths that can turn into cancer), they can be removed during the colonoscopy to stop cancer before it starts. Other colon-screening methods include flexible sigmoidoscopy, which is a procedure used to examine only the lower section of the colon, or a fecal occult blood test, which is used to detect blood in the stool (a sign of colon cancer).

Most people should begin regular colon cancer screening at age 50, but the starting age may be younger if you have certain medical conditions or a family history of colon cancer or related diseases—so talk to your doctor about screening recommendations.

For more information about screening for anal or colorectal cancer, call 1-877-ASK-RPCI (1-877-275-7724)

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