High-grade dysplasia indicates the presence of severe abnormalities and the need for further evaluation. Specialists in this area have set no formal recommendations for how often anal pap smears should be done. We believe that any gay or bisexual male who has had sex with another male, is HIV-positive, and has a history of anal warts should have a pap smear and possibly a biopsy of tissue from the anal canal. Bleeding from the anus may have other causes, as well, such as hemorrhoids, tears, or infection. Thirty percent of patients have either pain or the sensation of a rectal mass.
Symptoms only occur when the cancer has begun to grow.
People with anal cancer usually find out about it late in the disease when treatments are limited to surgery, chemotherapy, or radiation therapy, which do not have good recovery rates. In our study we are using anal pap smears to detect the early signs of anal cancer, namely the cell changes called dysplasia. We found that anal dysplasia can slow or revert to normal. None of the men in our study have developed invasive anal cancer. Some had severe dysplasia with pre-cancerous cells on biopsy, which can lead to cancer if not treated.