Gay and bi men, quite a few of us are familiar with sexual health testing.

But how comfortable are you with bringing up anal health if it wasn’t related to an STI?

The anus and anal health are super important, but the topic often gets stuffed in the can. Many people may find it taboo or embarrassing to talk about.

People with signs of poor anal health may avoid seeking medical attention out of embarrassment[1].

Symptoms of poor anal health include anal pain, unexplained bleeding, or bowel irregularity. Leaving these issues untreated could result in late cancer diagnoses or other serious conditions.

Health stigma is serious especially when it comes to anal cancer, but we can fight it by opening up about anal health.

 

Why is it important for the LGBTQ+ community to be aware of anal cancer?

LGBTQ+ individuals, particularly men who have sex with men (MSM), experience higher rates of anal cancer compared to the general population. This is because of increased exposure to HPV, HIV, and other risk factors[2].

Groups most at risk of anal cancer in our communities include:

Gay and bi men who have sex with men (MSM)

MSM are about 20 times more likely than heterosexual men to develop anal cancer.

People diagnosed with HPV-related gynaecological cancers

If HPV has played a role in causing cancer in areas of the body such as the vagina (front hole) or cervix, then the anus may be at risk too.

People living with HIV

MSM living with HIV are up to 100 times more likely to develop anal cancer than the general community.

People living with HIV are recommended to discuss periodic screening for anal cancer with their doctor and healthcare providers.

 

What exactly is anal cancer?

Anal cancer is a type of cancer that forms from abnormal cell growth in anal tissue. It’s caused by certain strains of HPV, which is sexually transmitted.

HPV is very common and nearly all sexually active people will get it in their life. In most cases, the body naturally clears HPV within 1-2 years with no symptoms.

However, some HPV strains can linger on the skin and make cells abnormal over time. If left untreated this can result in cancer.

 

How can we prevent anal cancer?

Despite what we just said above, the kicker is – anal cancer is super preventable!

How exactly? Let’s dive in:

1.      Vaccinate against HPV

The HPV vaccine can prevent many strains of HPV that linger in the body and can cause cancer. Simply, HPV vaccination = cancer prevention!

High-risk groups such as gay and bisexual men, MSM, and people living with HIV are recommended to get the HPV vaccine at any age.

If you belong to one of these high-risk groups, we recommend speaking to your doctor or healthcare provider about HPV vaccination.

If you’re looking to get the vaccine under age 26, you’re in luck – the vaccine is free for individuals under 26! However, if you’re over age 26, the vaccine will come at a cost. Feel free to discuss your options with your doctor.

For more info about HPV and the vaccine, check out our blog.

 

2.      Practice safe sex with condoms

HPV is sexually transmitted, and condoms can lower your risk of getting HPV.

However, HPV can be transmitted through skin-to-skin contact, passing through tiny breaks in the skin, so condoms alone offer limited protection.

Using a condom in tandem with the HPV vaccine will offer the best protection.

If you prefer condomless sex, get the HPV vaccine! It can protect you against other strains of HPV you may not have been exposed to.

 

3.      Early detection can make treatment of anal cancer much more effective

A digital anal rectal exam by your doctor is currently the best test to detect anal cancer. And no, it’s not a colonoscopy – the two exams are looking for different conditions.

If you are living with HIV, you are recommended to screen once you reach a certain age:

• Gay, bi, MSM, or trans women living with HIV over age 35 should be offered screening
• Cis-women, trans men or cis-men (not gay/bi) living with HIV over age 45 should be offered screening

Screening is important for PLHIV because of the high anal cancer incidence in individuals aged 50 and over. For immunocompetent individuals, a higher anal cancer incidence appears aged 60 and over.

 

What if I experience anal cancer symptoms?

Speak to your doctor if you experience any of the following symptoms:

• Change in bleeding patterns from the anus or rectum, unlike the occasional bleeding experienced if you have haemorrhoids
• A lump or growth near the anus
• Pain in the anus or surrounding area
• Itching or discharge from the anus
• A change in your usual bowel habit

A lot of these symptoms may also be caused by rectal gonorrhoea, haermorrhoids, and fissures. Regardless, it’s best to find out what’s causing any discomfort!

And if you are 45 years and over, remember to do your free bowel screening kit. It can actually pick up on advanced anal cancers too!

However, the kit is not a strict replacement for a rectal exam, so remember to speak to your doctor about symptoms and whether you need to do an exam.

Opening up about anal health

It’s natural to feel anxious or a little embarrassed when you are expected to drop your trousers around a medical professional! However, your doctor has a duty of care to look after you, no matter where you are experiencing issues.

Talking about your butt shouldn’t be taboo. Your anal health matters, cause your ass is as much a part of you as any other body part!

Think of it this way: everyone has a butt and anal health affects all of us – so talking about yours isn’t weird, it’s wise.

Speaking up with friends, family, chosen family, and your doctor helps normalise the conversation.

 

So, don’t sit on it – if you feel something is off, get it checked out sooner rather than later, and don’t leave your butt behind!

For more on anal health and care, check out:

Anal care | healthdirect

IANS – Patient Support