BETTER LIFE
QUEER HEALTH
Anal Papilloma: Do We Have to Go There? BY JILL CRANK, CRNP, CHASE BREXTON HEALTH SERVICES Most of us don’t talk about this part of our body often. Of course, there aren’t many opportunities to talk about it. Even with our medical providers. But just like any other part of our bodies, the anal canal is important to your health. And anal papilloma is one health risk you should know about. So don’t be shy—read all about anal papilloma and then talk with your provider about your risks.
WHAT IS ANAL PAPILLOMA?
Anal papilloma is a medical term for the infection of the anal canal with the human papilloma virus (HPV). There are more than 40 different strains of HPV that can infect the genital areas (vagina, anus, buttocks, scrotum, and penis). It is passed through the skin during sexual activity. You can be infected with HPV and infect sexual partners even when you do not have any obvious symptoms.
WHAT CAN IT CAUSE?
HPV is often cleared by our immune systems within two years of infection. Some strains do not cause any visible or lasting harm. Other strains cause genital warts, while some cause cellular changes that may progress to cancer (but warts are not precancerous). These changes in the anus are called anal intraepithelial neoplasia (AIN), and can vary from low to high grade. High grade AIN is more likely to progress to anal cancer, but it can be treated if identified early.
WHO HAS IT?
Studies show that over half of sexually active men and women, regardless of sexual orientation, will be infected with HPV at some point. HPV and anal cancer are more common in people with HIV because it is harder for their body to clear the virus. It is also more common in men who have sex with men (MSM), as research indicates there is a greater likelihood of high-risk sexual behavior in this population. PAGE 20
FEBRUARY 2013
ARE THERE SYMPTOMS?
Usually symptoms are only present in advanced stages of anal cancer, but sometimes patients can experience itching, rectal bleeding, discharge, irritation, or problems with bowel movements.
WHO IS TESTED?
Currently, there are no formal guidelines for anal cancer screening. However, most HIV specialists are screening HIV infected men and women because of their established higher risk. The screening test (called an anal Pap smear) consists of inserting a moistened swab into the anal canal and sending the collected cells to the lab for testing.
TREATMENT
Anal warts can be treated with topical applications or procedures using lasers, electric currents, or surgery. If an anal Pap smear comes back with persistent atypical cells, or low or high grade AIN, the patient is referred for high resolution anoscopy (HRA). HRA allows the clinician to visualize the anal tissue closely and take a biopsy of suspicious spots. If the lesions are confirmed to be abnormal, the patient may be a candidate for treatment with topical applications or infrared coagulation (radiation that destroys the tissue).
PREVENTION
Unfortunately condoms do not protect 100 percent against anal papilloma, but they do reduce the chances of infection. Limiting the number of partners can help. The HPV vaccine (which targets four different strains of HPV) has been shown to significantly decrease AIN occurrence in MSM who have had less than 5 lifetime partners. The eligible age range is 9-26 years old for both males and females. Lastly, early detection by a health care provider can reduce negative consequences in high-risk patients. It is important to maintain a regular checkup schedule and speak openly with your doctor about any concerns you may have.
GAY LIFE MAGAZINE