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Social Stigma Prevents Anal Cancer Diagnosis and Treamtment

Stephen M RauhAccording to the American Cancer Society, the incidence of anal cancer has been on the rise in the U.S. since the 1970s, with a five-year survival rate of only about 71 percent if the cancer is caught in its earliest stage.

Faced with this reality, a best practice approach involves proactive screenings for the anal dysplasia that precedes a cancer diagnosis, according to Stephen Rauh, MD, managing partner of Rochester Colon & Rectal Surgeons (RCRS) and a nationally recognized specialist in colorectal surgery. Unfortunately, says Dr. Rauh, many primary care physicians – and even some specialists – are as uncomfortable as their patients about the topic.

“It’s wrongly associated with shame and privacy, and even highly trained physicians often don’t want to bring it up,” Dr. Rauh says, comparing the social stigma to that faced by breast cancer patients only a few decades ago.

Although the risk of anal cancer is proportionately highest among homosexual men, more women contract the disease due to the higher occurrence of anal sexual intercourse among women than men. Anal cancer is caused by the Human Papilloma Virus, and pre-cancerous anal dysplasia can usually be identified via an anal pap test, comparable to the exam used to diagnose cervical cancer (also caused by HPV). Once found, the dysplasia can be treated with a very high success rate before the cancer ever has a chance to appear.

“It’s classic preventive medicine,” Dr. Rauh says. “In my opinion, every time a woman is found to be at high risk for cervical cancer with an abnormal pap smear, that woman should be checked for anal dysplasia.”

RCRS, affiliated with Rochester General Health System since 1976, features a team of specialists highly trained in the detection of anal dysplasia among HPV-positive patients, using a combination of anal pap testing and high-resolution anoscopy. This work is led by Theresa Schwartz, MS, NP-C, who is credentialed in this subspecialty and a member of the International Anal Neoplasia Society, the world’s first professional organization devoted to the prevention and treatment of anal cancer.

“Our goal is to help people – physicians primarily, but also patients – feel more comfortable with being screened for anal cancer,” says Dr. Rauh. “That’s where it all starts.”

For more information about screenings for anal dysplasia, or to arrange a referral, contact Rochester Colon & Rectal Surgeons at 585.266.8401.