Anal dysplasia is a pre-cancerous condition in which lesions have formed in or near the anal canal. These lesions are skin cells that have changed into abnormal cells. These are often caused by human papillomavirus (HPV), which is also the cause of anal warts.
Anal dysplasia is not cancer, but anal dysplasia lesions can turn into cancerous tumors, so it’s important to get screened.
Anal dysplasia can be treated. It requires attention from doctors who specialize in diagnosing it and caring for patients who have it.
Who is at risk to get anal dysplasia?
Some people have a higher risk of getting anal dysplasia. You may have a higher risk if your medical history includes any of these:
- Human papillomavirus (HPV) infection in the genital or anal area
- Abnormal Pap test that includes HPV
- Abnormal cervical Pap smear
- Positive human immunodeficiency virus (HIV) test
- Medications that weaken the immune system, such as treatments for rheumatoid arthritis or organ transplant
Your risk also may be higher if you:
- Have had anal sex without a condom
- Smoke cigarettes
- Use injection drugs
- Are 40 or older
- Have had multiple sexual partners
What are the symptoms of anal dysplasia?
Anal dysplasia often has no obvious symptoms that you can feel or that your doctor can see during a routine examination. Sometimes symptoms don’t appear until anal dysplasia has advanced to anal cancer.
When symptoms do appear, they may be similar to symptoms of other common conditions, such as hemorrhoids or an infection. These include:
- Pain or pressure
- Feeling a lump near the anus
- Bleeding
- Itching
- Discharge of pus or mucus
- Changes in bowel habits or increased straining during bowel movements
If you think you are at risk for anal dysplasia, you should ask your doctor about getting screened, even if you haven’t noticed any of these symptoms.
Getting screened for anal dysplasia
Screening begins with an anal Pap test. Your doctor will put a cotton swab in the entrance of the anus and rotate the swab for a few seconds. This is a way to collect cells that can be sent to a lab, where they will be viewed under a microscope to check for abnormal cells and human papillomavirus (HPV).
High-resolution anoscopy (HRA)
If your Pap test finds abnormal cells, you will be referred for a high-resolution anoscopy (HRA). HRA is a procedure that allows a doctor use a short, thin instrument called an anoscope to look directly into the anal canal for areas that appear to be abnormal. The doctor can then treat any lesions or anal warts. Or the doctor may choose to do a biopsy, which involves removing a small piece of tissue that can be examined in a lab.
Anal dysplasia treatment options
To treat lesions or anal warts caused by abnormal cells, your doctor may use a procedure called electrocautery(EC). In EC treatment, the doctor uses a small device to heat, destroy, and remove the cells on the surface of the lesion or wart. If there is too much to treat in one session, your treatment may be completed at the next visit.
EC can be done in the doctor’s office with minimal discomfort. Recovery from EC treatment is brief, and EC has fewer risks than surgery. You will have a follow-up HRA three to six months after your EC treatment.
Another option for treating lesions is a topical cream that is applied twice daily for five days, followed by a break of nine days. That cycle is repeated four times. The most common side effects from the cream include irritation, itching, or pain in or around the anus.