Symptoms of Anal Cancer

Changes in bowel habits should be discussed with a physician

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Some of the signs and symptoms of anal cancer are non-specific and are similar to other less serious conditions. For that reason, it's important to get symptoms involving the anus and/or changes in bowel movements checked out by a physician.

Cancer of the anus is considered rare when compared to other forms of cancer. It's estimated that 0.2% of people will be diagnosed with anal cancer in their lifetime. However, the rate has been increasing by about 2% each year.

Older man speaks with a healthcare provider.

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The anus is at the end of the digestive tract. It is a collection of muscles that form a ring and is about 4 to 5 centimeters (about 1.5 to 2 inches). It is the opening through which stool (poop) passes out of the body.

Learn more about the symptoms that can occur with anal cancer and why some groups are at greater risk.

Frequent Symptoms

There are several symptoms of anal cancer. Some of them may occur earlier in the disease course than others. Symptoms might depend on the exact location of the cancer and if a tumor has begun growing. It is also true that in about 20% of cases of anal cancer, there are no symptoms at all.

Many anal cancer symptoms are similar to other conditions, so it is important to not assume that any bowel symptoms are from a less serious problem. Hemorrhoids, for instance, are quite common and can also cause rectal bleeding and a mass in or around the anus.

However, only a physician will be able to look at the area and find the cause of the bleeding or the bulge. It may be necessary to have a digital rectal exam, where a gloved finger is inserted into the anus, for a doctor to make a diagnosis.

An anal Pap smear may also be used to confirm or rule out anal cancer. This is why new symptoms in the anal area or with bowel movements should be discussed with a physician.

Some of the most common symptoms of anal cancer are:

  • Abdominal pain, bloating, or cramping
  • Bleeding from the rectum
  • Blood on the toilet paper after a bowel movement
  • Bulge or a bump (a mass) in the anal area
  • Pain in the anal area

Other symptoms of anal cancer can include:

  • A feeling of fullness in the anal area
  • Changes in bowel movements
  • Discharge of other fluids from the anus
  • Itching in or around the rectum
  • Loss of bowel control (incontinence)
  • Narrow stools
  • Swollen lymph nodes in the groin or the anal area

Rare Symptoms

Anal cancer may cause other symptoms that are less common. Some of the less common symptoms that have been reported include:

  • Fever
  • Unintended weight loss

Complications/Sub-Group Indications

Anal cancer is one of the more rare forms of cancer. However, some studies show that certain groups of people may be at a greater risk of developing anal cancer. Some people are also at higher risk of being diagnosed later in the course of the disease and of having a worse overall prognosis.

For that reason, those who may be at a higher risk should discuss anal cancer with a healthcare professional. There may be a lower threshold for reporting symptoms that may be related to anal cancer and getting seen by a doctor for a physical exam.

HIV-positive Status

People who have been diagnosed with HIV are at greater risk of developing certain types of cancers. Anal cancer is more common in those who are HIV positive and this rate has been increasing in the United States.

Race and Sex

Overall, with all races taken into account, anal cancer occurs slightly more often in women than it does in men. However, White women, non-Hispanic women, and Black men all have rates of anal cancer that are higher than the rate that includes people of all races and sexes.

Socioeconomic Status

The diagnosis and treatment of anal cancer is closely tied to socioeconomic status. It has been noted that insurance status, race, income, employment, and partnership status are all important factors in receiving a timely diagnosis and effective treatment.

One study noted that patients who had Medicaid had poorer outcomes, including more relapses and deaths, when compared to those with private insurance. Further, patients of racial and ethnic minorities also had less time to relapse and higher mortality when compared to patients in the racial majority.

When to See a Doctor

At first, the symptoms of anal cancer may not seem alarming. For some, there may not be any symptoms at all. However, it is important to get anal cancer diagnosed early. The earlier the diagnosis, the better chance there is of having a good outcome.

Having signs and symptoms that suggest a problem in the anal area is a reason to see a doctor. This includes bleeding from the rectum or blood on the toilet paper after wiping, abdominal pain, and changes in frequency and consistency of bowel movements.

For some groups, anal cancer screening may be recommended. Screening tests are done even when there are no symptoms, especially for a person who has an increased risk of this type of cancer. There hasn't been enough study done to make a broad recommendation for anal cancer screening.

This type of cancer is rare and therefore some aspects are under-studied. However, some experts may recommend screening every year or every two or three years for their patients who are at risk.

The groups that might be screened for anal cancer may include:

Some experts also recommend screening for anyone with a history of anal warts and women older than 45 years old who are HPV-16 positive.

A Word From Verywell

A frequent problem with the diagnosis of anal cancer is the delay in seeking care. There are a variety of reasons that this might happen.

The first, and most obvious, is that symptoms surrounding digestion and our bowel are difficult to discuss. Some people are embarrassed to talk about bathroom problems, even with healthcare professionals. There may also be stigma about digestion in certain cultures that makes getting a diagnosis more challenging.

However, as with other cancers, getting a diagnosis earlier in anal cancer is important to have a better outcome. Anal cancers may also be more likely to be found on an emergency basis than other types of cancers. This is more common among older patients and those in certain socioeconomic groups.

Reversing this trend will mean helping the public, especially those in the groups that are at greater risk, and indeed healthcare providers, become more comfortable with addressing digestive health.

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