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Anal Dysplasia Screening

What is Anal Dysplasia?

Anal dysplasia is a condition in which some of the cells within the anus have transformed into abnormal cells.

Anal dysplasia is not cancer, but it is a pre-cancerous condition. In other words, if the abnormal cells are left untreated, they can turn into cancerous tumors.

In most cases, anal dysplasia is caused by the human papillomavirus, or HPV.


What are the risk factors?

There are several things that can increase your chances of developing anal dysplasia:

  • Exposure to the human papilloma virus
  • Having several sexual partners
  • Anal intercourse
  • HIV/AIDS infection
  • A history of anal warts,
  • A history of sexually transmitted infection
  • Taking drugs that suppress the immune system
  • Being over 50 years old
  • Smoking
  • Anal cancer has a very high cure rate if it is found before it has spread

What are the symptoms?

Anal dysplasia often has no symptoms at all.

The following are the most common symptoms of anal cancer:

  • Bleeding from the anus
  • A lump at the opening of the anus
  • Pressure or pain in the anus
  • Discharge of mucus from the anus
  • Change in bowel movement patterns—having more or fewer bowel movements
  • Increased straining during bowel movements
  • Swollen glands in the anus or groin

If you experience any of these symptoms, it is important to see your doctor to determine if you have anal cancer.

Anal Dysplasia Screening

How is it diagnosed?

Anal dysplasia is diagnosed with the use of two tests: an anal pap, and High Resolution Anoscopy, or HRA.

In an anal pap, a swab is used to collect some cells from the anus. These cells are then examined under a microscope to determine if any of them are abnormal.

High Resolution Anoscopy is a procedure that allows a doctor to look at cells within the anus.

First, a plastic anoscope coated in an anesthetic gel is inserted into the anus. Then a swab coated in vinegar (Acetic Acid) is inserted through the anoscope and into the anal canal. The vinegar will turn any abnormal cells white.

A colposcope, a tool that provides magnified images. The colposcope provides a clear picture of the anal canal, allowing the doctor to see any abnormal cells.

If any lesions are discovered, a biopsy can be performed during the HRA procedure. A biopsy is the only way to make an actual diagnosis of anal dysplasia. Pain after a biopsy is minimal, and most patients only require over the counter medications like Tylenol or Advil for pain relief.

If a biopsy is performed, the cells will be examined by a pathologist to determine if they represent a low-grade or high-grade lesion. Cancerous cells may also be identified. Low-grade lesions only need to be periodically monitored, whereas high-grade lesions will require further treatment.

How is anal dysplasia treated?

At the St. John’s Episcopal, anal dysplasia is treated with Cautery.

Cautery short bursts of electricity to destroy—or “ablate”—abnormal cells. Cautery performed with some sedation. It is nearly painless and causes minimal bleeding.

Local anesthetics along with sedation are used to keep you comfortable during the procedure. No suppositories or enemas are required ahead of time. For many patients, two or three treatments will be needed to ensure that all abnormal cells have been destroyed.

After you have had Cautery or fulguration for anal dysplasia, you will need regular anal pap tests or HRA to ensure that you have no further issues.