Anal cancer incidence has increased in recent years, and there are no consensus screening guidelines. Researchers found the use of home-based anal self-sampling kits improved screening.1
The American Cancer Society estimates there will be twice as many new cases of anal cancer among women as among men in 2023.2 The most important risk factor is infection by human papillomavirus (HPV), which can infect cells lining the genitals, anus, mouth, and throat. People can contract it through vaginal, anal, and oral sexual activity.3
“The CDC is calling for more research on anal cancer screening and what is the best way to screen for it,” says Jenna Nitkowski, PhD, postdoctoral research fellow at the Center for AIDS Intervention Research of the Medical College of Wisconsin. “We randomized patients to a home or clinic condition. The home arm received kits mailed to their houses, and they did a self-swab in the anal canal.” The other arm was sent to a clinic for the swab.
Investigators wanted to see if the screening worked better in the home setting or in the clinic. “We found a high uptake of the mail kits and high acceptability of that,” Nitkowski says. “About 98% of participants said they’d be willing to do the home self-swab again, and almost all participants had little or no pain from doing it.” The self-swab kits worked as well as the clinic swabs at successfully screening for anal cancer, she adds.
Other studies and countries have used self-sampling kits for cervical cancer screening, and these have been successfully employed by women. “Right now, the U.S. doesn’t have anything like that, but Europe has already implemented those self-sampling kits,” Nitkowski says. “Sweden has a really good experience with rates of cervical cancer dropping because they’re reaching a lot of women with these at-home kits.”
The CDC’s latest recommendations are that sexual minority men receive a digital anal-rectal exam annually. Women with a medical history of organ transplant or any vaginal cancer also are at high risk, Nitkowski says.
The self-tests at home empower people to conduct the screening safely in their homes. The results of this study (and other research) suggest this would be an effective and successful screening method for anal cancer, and there are no reasons why it should not work for women.
“I don’t see a reason not to do it,” Nitkowski says. “If you do receive a result and you have a question about it, usually a person could have access to a clinician to ask questions, so they’re not left out in the cold.”
For women who want more control over their sexual health, and for those who have experienced sexual trauma that makes clinician genital screening exams unfeasible, this is a good option, she adds.
REFERENCES
- Nitkowski J, Giuliano A, Ridolfi T, et al. Effect of the environment on home-based self-sampling kits for anal cancer screening. J Virol Methods 2022;310:114616.
- American Cancer Society. Key statistics for anal cancer. Page last revised Jan. 12, 2023.
- American Cancer Society. Risk factors for anal cancer. Page last revised Sept. 9, 2020.
Anal cancer incidence has increased in recent years, and there are no consensus screening guidelines. Researchers found the use of home-based anal self-sampling kits improved screening.
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