Diagnosis through tests & procedures

Anal cancer can be found through different tests and procedures:

Digital Anal Rectal Exam (DARE)

The main purpose is to detect abnormalities of the anal canal including a mass, abnormal thickening, an area of hardness, a lump, areas of localized tenderness, or an ulcer. Sometimes abnormalities can be felt before cancers and precancerous lesions become advanced.

Routine screening during high-resolution anoscopy (HRA)

Areas most worrisome or possibly suggestive of cancer are evaluated and biopsied. These include areas in the anal area that are ulcerated, thickened, and areas containing abnormal blood vessels. Sometimes the biopsy can detect early cancers. The goal is to biopsy the most abnormal-appearing areas during exams. The tissue is examined at a microscopic level and the severity of the lesion can usually not be seen by without HRA

During surgical procedures

Hemorrhoid removal, treatment of anal canal fissures (painful tears in the anal area), and fistula management (an abnormal connection between the internal anus and the outside skin). Sometimes incidental cancers are also found during surgeries to remove anal condylomata (warts). HRA is not always utilized during these surgical procedures.

An invasive anal squamous cell carcinoma (anal cancer) can only be diagnosed through the biopsy of a suspicious lesion or an abnormal area in the anus.