Anal Cancer Prevention Program

The Anal Cancer Prevention Program at Mount Sinai is dedicated to research and the clinical care of patients at risk for anal cancer. We are also experts in the diagnosis and treatment of anal and genital warts (condyloma) and sexually transmitted infections (STIs).

Most anal cancers are caused by particular (oncogenic) types of the Human Papillomavirus (HPV). HPV is very common and most sexually active adults will likely get exposed to it at some point in their lives. There is now a very effective vaccine to prevent infection with the most concerning types of HPV. The vaccine is most effective if it is given before sexual activity begins. Therefore, many adults are incompletely protected or have never received the vaccine at all.

Who is at risk for anal cancer and who should be screened for it?

While anal cancer is a relatively rare cancer in the general population, anal cancer affects certain groups of patients disproportionately. Individuals at increased anal cancer risk are:

Persons living with the Human Immunodeficiency Virus (HIV), regardless of gender or sexual preference; for those patients, screening is generally accepted clinical practice and recommended to start at age 35.
Men who have sex with men who are HIV negative; some experts recommend starting anal cancer screening at age 45 for those individuals.

In other patient groups, the role of anal cancer screening is not quite clear yet and more research is required to determine whether and at what age screening for anal cancer should begin.

This is true for:

Women without HIV infection who have previously been diagnosed with genital cancer (particularly cervical and vulvar cancer) or with precancerous lesions in the genital tract.
Individuals whose immune system is suppressed, particularly patients who have had a transplant and receive medication to prevent rejection of the transplanted organ.

If you are unsure whether anal cancer screening is appropriate for you, please ask your primary care doctor or nurse practitioner.

High-Resolution Anoscopy and No-Show Policy

High-Resolution Anoscopy (HRA) is a specialized procedure and there is a shortage of physicians skilled in the technique. Therefore, the wait times for appointments can be quite lengthy. We therefore respectfully ask patients who cannot make it to their appointment to please cancel at least 24 hours in advance to allow other patients on the wait list to be seen in their place. Appointments can be scheduled, canceled, or rescheduled by calling 332-243-0177 or conveniently through the Mount Sinai MyChart electronic patient portal.

If you are anxious about your procedure and have additional questions, please contact us and we will make every attempt to accommodate your concerns and make it a comfortable experience. Some patients may benefit from anxiety medication that can be taken 30-60 min prior to the examination. Medication can be prescribed by the referring doctor or by one of our physicians after an initial consultation.

You do not have to prepare for the procedure in any special way (just take a shower in the morning, but do not douche or use enemas; you can eat, drink, and take your medications as per usual).

Please take note of the following policies:

No-show policy - to prevent patients who repeatedly do not show up for their appointment/procedure from being rescheduled, we enforce a policy that prevents patients from being rescheduled if they fail to show TWICE for a scheduled appointment without canceling at least 24 hours in advance.

This is in the interest of being fair to patients who want to get screened for anal cancer and have a challenging time getting an appointment due to the wait time.

We are making every effort to be efficient and value your time and ask that you do the same - please arrive 15 minutes prior to your scheduled appointment/procedure time to allow for timely check-in, completion of paperwork and procedure preparation. New York City traffic can be grueling so please plan accordingly. If you are more than 15 minutes late to your appointment, we will try and still see you on a case-by-case basis, but you should be prepared to have to reschedule your procedure.

Thank you for your consideration.

Research Opportunities/Clinical Trials