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Anal Pap smears are currently being evaluated for a possible role as screening tests for anal pre-cancer. The procedure involves the sampling of cells from the anal canal and uses similar technique to those used in cervical cancer screening.
Although there are few published data on this, it does not seem to matter whether you douche (wash inside the anus) before having an anal Pap.
You will first be asked to take down your lower garments, before lying on your left side. The sample will then be collected by inserting a moistened swab 5cm into the anal canal and firmly rotating it for about 1 minute. The material from this swab is then mixed with solution in the container and sent to the laboratory for analysis.
The procedure may be a little uncomfortable. There may be some minor bleeding immediately afterwards, particularly for those with pre-existing lesions of the anal canal, such as anal warts. It is possible that you will notice a small amount of blood in your first bowel motion following the procedure, but this should not persist.
Results typically take two weeks to become available.
The sensitivity of this test is quite low – in other words, it sometimes misses cases of HSIL and cancer. Also, on occasions, the result may be misleading. For these reasons, it is only currently performed in specialist centres, and you must discuss the meaning of your result carefully with your specialist.
The table below lists the common results of anal Pap smears, and gives some possible implications.
Note: None of the above results indicate that cancer is present.