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The program recommends that anal cancer screening be performed in high-risk-populations: HIV-positive men and women, MSM, women with a history of vulvar or cervical cancer, and organ transplant recipients. Anal cytology ie, the anal Pap test has been recommended by several research groups for screening at-risk populations for anal cancer; this test is adapted from the principles of cervical screening. When anal cytologic findings are abnormal, HRA should be performed to detect anal dysplasia. The incidence of anal human papillomavirus HPV and anal cancer is growing among men, in whom HPV has been shown to be a major cause, if not a necessary cofactor, in the development of anal cancer. Understanding the basic anatomy and histologic characteristics of the anus and perianal area is essential in comprehending the pathologic possibilities of the region. He also has a pack-per-year history of smoking tobacco. Given all of the available data and given that the anal Pap test is an uncomplicated and quick procedure, the rates seen for anal cancer screening in the clinical setting are low, as noted by Kreuter and Wieland 16 and the clinical experience of the author R. We stated previously that all abnormal findings at anal cytologic screening deserve further investigation with HRA.

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