Anal pap smear

In the news coverage of Farrah Fawcett's death from anal cancer, there has been mention of an anal pap smear that can detect the early signs of cancer, sometimes offered to gay men. I've never heard of such a thing. Any experiences with this test?

I had never heard of it, but (no pun intended) there it is....

http://en.wikipedia.org/wiki/Anal_Pap_smear

For almost as long as the Papanicolaou smear has been accepted, researchers have experimented with other applications such as oral, genital, and anal cancer screening. Anal pap smears have not become common for a number of reasons, not the least of which is quality control. The development of the ThinPrep Cervical Pap method has dramatically increased the accuracy of that cytology, while casting further doubt on the accuracy of an anal pap. Since an anal pap is done blindly, there is no assurance of an adequate cytological specimen being collected and the probability of contamination with fecal matter is nearly certain.

Anything which potentially saves lives is worthwhile, and for the target group of males who have unprotected anal sex, as well as HIV+/AIDS males and females, a reliable anal pap would be beneficial. Presumably a variation of the ThinPrep method may provide a solution as the test also supports HPV and Chlamydia identification, and could potentially detect occult blood.

Until such time as it matures into an accepted standard, a simple DRE is the best step towards early diagnosis of anorectal malignacies. Persons at higher risk, including those with HPV who engage in anal sex, should have a more comprehensive examination with anoscopy or sigmoidoscopy at regular intervals.

I know people who were involved in clinical trials using anal pap smears to detect HPV in men. A positive result argues for a more specific high resolution anoscopy to look for abnormalities such as dysplasia (precancerous lesions) that can then be treated much less invasively or with fewer repercussions than waiting for full cancer to develop. HPV is a virus causing both cervical and anal cancer. The virus is easily transmitted by touch, not requiring direct penile/vaginal or anal penetration.

I have posted some links to videos showing this procedure and especially the high resolution anoscopy in the video section

http://www.zity.biz/index.php?mx=forum;ox=display;topic=76623.0

My anal pap is described here

http://www.zity.biz/index.php?mx=forum;ox=display;topic=48429.msg543897#msg543897

Post #69

Http://www.google.com/url?sa=t&source=web&cd=10&ved=0CEgQtwIwCQ&url=http%3A%2F%2Fm.youtube.com%2Fwatch%3Fv%3DytOTNi8yVOc%26desktop_uri%3D%252Fwatch%253Fv%253DytOTNi8yVOc&ei=hixCUvDaJuml2wXGloCYBA&usg=AFQjCNE9k92-EUG3SLGQb5Z-TWecn3xnZw

I wanted to post on this because a GP was speaking to me today about some various tests and she brought up anal paps as we were discussing several differentials on a theoretical patient case. In a very final tone she assured me she would not be doing them as a part of regular screening so if this is popular opinion I wouldn't get my hopes up for this to become standard practice in healthy asymptomatic patients. In the zity biz doctor/patient world I suppose it could be standard practice though 😉

At my last physical (August) my doctor (of 14 years) and I had the usual "chat" when that was done he said "ok let's do your physical, everything off (tossing a paper gown on the table) open in the back, have a seat up here" (tapping the end of the table). He left the room.

I took everything off, put the stupid paper gown on, left my clothes in a pile on the chair, my underpants on top of the pile. And sat on the crunchy paper on the table.

He returned in 5 minutes, "up on the scale" he stood behind me adjust in the scale my bare butt hanging out of the paper gown.

Back to the table where he did all the usual things head to chest, had me lay down, felt my belly and the top of my groin. Then legs, knees, feet.

He then said "ok sit up". He sat on his stool and said "we"ll take a look at your scrotum, do a testicular and check for hernia". "Then we'll take a look at your bottom, today I'm going to go an anal pap, we did on 8 years ago, just a swab into your anus (an oversized q tip) and I'll spin it around then out. I can't use lube so it will be a bit scratchy".

So I stood up, he lifted up the gown and tucked it under my arms, felt my sac & balls, quick feel of my penis, stuck the finger in my groin and said "head to the left and cough" then the other side.

Then "ok let's take a look at your backside". I turned around and put my elbow on the table, he tapped my inner leg said "spread a bit" he felt around, then said "ok swab in" and he pushed it in my hole. It felt like a steel wool pad up there. He swirled it round a few times, pulled it out and said "stay down". I heard the cap go on the swab and the luv being squeezed out. Then the cool lube on my anus. "Relax and deep breath" and he pushed in. He spends quite a bit of time then says "ok let's check the prostate". He went slightly further and pushed down hard. I tensed up "relax, I'll be done quick" he pushed down again and tensed and flexed my penis and didn't realize that I dripped some liquid/cum. He pulled out, he wiped the lube off my hole and handed me a tissue and said "I know I push down hard on the prostate, it will feel like you're dripping a bit today".

I dabbed my penis then saw the puddle of cum on the step at the end of the table. I was horrified. He said "don't worry, I'll get it". He reached over and tossed me my underpants, then he tossed s tissue on the puddle. He just kept talking like it didn't happen.

I continued to get dressed, we finished our conversation, we shook hands and he said "see you next year" and left.

So has anyone had an anal pap??

No, I've never had one.

Was there a particular reason why he felt that you needed one?

Yes...had my first one at my last physical.

I'd love to visit your doc, Boshuy69

I have never had one. But I have a friend who is a few years younger then me and had one done.

Here's one I posted two years ago in a different thread, HPV swab by my PCP around 2006 (just had a second one done by a young PA at my new dr. in LA, 10/16, see below.)

First went like this, was fairly memorable:

"I know this is an old thread, but I just spotted it and so I'm weighing in now -

I had the equivalent of a Pap smear, but for guys. It consisted of the same thing as women get (I think) and for the same reason: looking for pre-cancerous and cancer cells, in the anus instead of the uterus this time.

I had this done in 2006, when Gardasil started being pushed by the drug company (and legislators, who were being plied with contributions from the drug company) and doctors started testing more people, including guys, for the HPV virus (cause of genital warts and an infrequent form of cancer - Deaths due to HPV/cervical cancer in women each year, around 4,000; men, HPV/anal cancer, 1,800.)

During one of my few physicals, Dr. G asked if I had ever, at any time in my life, etc - had sex with men, either giving or receiving. I made him wait, then said "Yes I have" without giving him any info. He paused, then told me to come back in a week for a "smear" as he put it. I was fairly puzzled, looked up the procedure (and drug, starting to be pushed heavily although it was arguably causing a few deaths each year, and the AMA said at the time that there were no 10-year studies of safety and efficacy because it hadn't been out for 10 years. No track record. At the time, they advised against HPV vaccinations.)

Back to Desert ____ the following week, told by the assistant Jordan to take off everything below the waist, I kept shirt and socks. Up on the table on my hands and knees - Dr. G came in, said with a grin "Here's where we get to know you", started by plunging a lubed finger in my ass, followed by a scope - cold steel going in several inches; I could feel it jerking as my pucker tried grabbing it. Next he reached for a speculum, inserted that and started ratcheting it open, stretching me wide. I was dreading what might be coming next.

He picked up something else and said "I have to get samples from a few different places" and started scraping inside my rectum here and there with what felt like a potato peeler. 30-45 painful seconds, he was done; I was allowed to recuperate for a few minutes before Jordan hoisted me down off the table. Very slippery from the lube until I could get home and shower, asshole was fairly sore for a few days after. (Don't know where I got the idea that the test would be something like a Q-tip quickly inserted.)

I wasn't given the drug at the time, the MD had several concerns about it also and wanted to hold back, at least until some results from long-term studies came in. However, it was offered: at the time it was 2-3 injections of Gardasil spaced a few weeks apart, for roughly the price the treatment is today - $400.

I told my then-girlfriend that I'd had this done, and we compared notes (she couldn't quit snickering) on how similar the procedures were, for all the differences in where they were done. She kept me away from The Grail for several days after her smear, my "Pap smear" didn't affect us in any way other than I preferred to stand instead of sit for a day or so. Anyone else have any similar HPV testing?"

10/16 - Second time was evidently SOP due to the physician's West Hollywood/UCLA location, for what are probably very "active" populations, to say the least. Second time was more like a swab - told to pull everything down to my knees and lie on my stomach on the exam table; the PA showed me what was going in next - 3" tree-shaped pipe cleaner, complete with bristles.) Had to be dry to work; he apologized and pushed it in using thumb and forefinger; after a few seconds and rotating it quickly, Done. Totally painless, I was relieved it was nothing like the first time.

Was told they liked to test all "unprotected" clients (meaning Gardasil-free) every year or two, that HPV was getting to be more commonplace.

Gay doctors in NYC do them regularly, whether they have discussed the type of sex positions a patient has had or not, and so did my MA and ME doctors.

What's all this crap about Big Pharma, Big Oil, Big Tobacco, or Big Whatever you call it, greasing the palms of politicians to get legislation in their favor? Politicians KNOW that whatever money they take will be published in the press by their adversaries from the other party. (Look at the Clinton Foundation being scrutinized). The worst we ever did in Big Pharma was to feed lunch to Dr.'s and their office staffs. I've now been told that this has been severely limited by FDA.

Ohio State University Hospital will not allow any student, interne, resident, or staff member to have on their person any pen, note pad, or anything else that has the name of any drug, or drug company's name printed on it. The only literature that can be left are peer-reviewed clinical reprints, no promotional company literature, file cards, etc.

If anything, the pendulum has swung in the opposite direction to being overly cautious about possible indoctrination and influence by drug companies. No one talks about the programs that supply needed medications to those who can't afford to pay for them, done by the drug's manufacturer, or the tons of extra samples that are left with Dr.'s to give to their patients on fixed incomes.

Sorry for going off topic, but this CONSPIRACY THEORY has gone too far.

Here's an addendum I was trying to add to my post a few days ago - Wall Street Journal and Reuter's articles on how Merck (Gardasil's manufacturer) lobbied congress and state legislatures to make Gardasil mandatory for school children; had almost succeeded in 23 states and DC before backlash from parents and religious groups caused Merck to drop their effort. These are from 2007, about the time I was tested initially and first looked into the vaccine..

http://www.wsj.com/articles/SB117200727319814015

http://www.reuters.com/article/us-merck-gardasil-idUSN2022501520070221

For slightly different perspectives, also check Judicial Watch, Forbes and the NIH for more.

My doctor does one yearly.

I think both men and women shpuld have it done. Better knowing than not knowing.

I’m asked to rake a swab of my anus every time I go for a sexual health check.

I get one with my routine STD testing.

Do they use a scope or lube? Or does it just go in dry?

Whenever I got a DRE the doc would wipe a finger on a test plea and send it in for analysis. No swap was ever used. Now they advertise do it yourself test, poop, sample it and send it in in a kit\ specifically designed for it.

My guess is that is an occult blood test, to see if there's something bleeding in your digestive system.

I've been given a swab by the nurse and asked to go to the restroom and insert it rectally then swirl it around and return it to check for STD'S. Wished he would have just done it for me. Felt very awkward to do it myself and worried I might have done it wrong in some way.