What tests are performed to diagnose anal cancer?

To diagnose anal cancer, a doctor typically reviews the patient's medical history and asks about symptoms and family health history. Afterward, the doctor may perform a digital rectal exam (DRE), which involves inserting a lubricated, gloved finger into the lower part of the rectum to feel for any lumps or abnormal areas. Additionally, the doctor may order specialized tests for the anus and rectum, such as anoscopy or proctoscopy, and a biopsy may be taken from any suspicious area to confirm the diagnosis [1].

Digital Rectal Exam and Initial Tests

The digital rectal exam (DRE) is a crucial initial step in diagnosing anal cancer. During this exam, the doctor gently inserts a lubricated, gloved finger into the lower rectum. The goal of this exam is to feel for any lumps, swellings, or unusual areas that might indicate a tumor. Although simple, this exam can provide valuable information about the presence of abnormalities in the anal and rectal region [1].

In addition to the physical exam, the doctor will collect detailed information about the patient's symptoms, such as anal bleeding, a mass near the anus, pain or pressure in the anal area, itching or discharge, or changes in bowel habits, such as narrowing of the stool or a frequent urge to have a bowel movement [1]. The patient's family health history and potential risk factors are also inquired about.

Specialized Tests and Imaging

After the initial exam, the doctor may request more specialized tests to examine the anus and rectum with greater precision. These tests include:

• Anoscopy: This procedure uses a short, lighted tube called an anoscope to examine the anus and the lower part of the rectum. There is also a type called high-resolution anoscopy, which uses a special magnifying device (colposcope) with the anoscope to examine these areas more clearly [1].
• Proctoscopy: This is a procedure in which a thin, tube-like instrument equipped with a light and lens is used to look inside the rectum and anus [1].
• Endo-anal or Endorectal Ultrasound: In this procedure, an ultrasound probe is inserted into the rectum to provide detailed images of the surrounding tissues [1].

These tests help determine the location and size of any suspicious lesions and guide the doctor in performing a biopsy.

Biopsy: Confirming the Diagnosis

A biopsy is the only way to confirm a diagnosis of anal cancer. During an anoscopy or proctoscopy, the doctor can take a small sample of suspicious tissue [1]. This sample is sent to a laboratory to be examined under a microscope by a pathologist to determine if the cells are cancerous. If cancer is confirmed, the biopsy can also identify the type of anal cancer, as squamous cell carcinoma is the most common type [3].

Importance of Early Detection and Follow-up

Early detection of anal cancer is critical for improving treatment outcomes. If you are experiencing any persistent symptoms such as anal bleeding, pain, or changes in bowel habits, it is essential to consult a doctor to perform the necessary tests [1]. Early diagnosis can help in initiating treatment in the early stages, which increases the chances of recovery. For more information on this topic, you can visit the page Anal Cancer: Symptoms, Early Diagnosis, and Treatment Options (Arabic).

After the diagnosis, the healthcare team will develop a personalized treatment plan based on the stage of the cancer, the patient's general health, and their preferences [1]. It is important to adhere to periodic appointments and follow-up with doctors to ensure the best possible care.

Medical references

• Anal Cancer
• What Is Anal Cancer?