Quick Answer: HPV can cause anal cancer through persistent infection with high-risk strains like HPV 16 and 18. Most people have no symptoms. Anal Pap smears and high-risk HPV tests are key to early detection.
This Isn’t Just a Gay Men’s Issue, It Affects More People Than You Think
There’s a persistent myth that anal cancer from HPV only affects gay men. While men who have sex with men (MSM) are at significantly higher risk, especially those living with HIV, the truth is more complicated. Women with a history of cervical HPV, people with weakened immune systems, and yes, even straight cisgender men can develop HPV-related changes in anal tissue that lead to cancer.
Anal cancer rates have doubled over the past two decades, particularly among people over 50. Yet screenings lag behind cervical care, even though the underlying virus is often the same. Unlike cervical Pap smears, which are routine for many people with a cervix, anal Pap testing is not part of standard care, meaning most cases are caught late, when treatment is harder and recovery more intense.
And here’s what makes it dangerous: HPV in the anus usually doesn’t cause symptoms at first. No warts. No pain. Just silent cellular changes that might not be discovered until a tumor starts forming. The people most likely to get diagnosed late? The ones who were never told they should test in the first place.
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How HPV Actually Causes Anal Cancer: What’s Going on in Your Cells
HPV (Human Papillomavirus) is a skin-to-skin virus. It’s incredibly common, most sexually active people get it at some point. But certain high-risk types, especially HPV 16 and 18, can cause changes in the lining of the anus. These strains integrate into your DNA and start messing with cell regulation. The body usually clears the virus within a couple of years, but sometimes, it sticks around. That’s when the risk begins.
Over time, this persistent infection can lead to a condition called anal intraepithelial neoplasia (AIN), a precancerous state where abnormal cells begin forming. AIN 1 often resolves without treatment, but AIN 2 and 3 mean moderate to severe dysplasia. If undetected, these cells can become malignant. What’s terrifying is that you may feel nothing while this is happening.
According to the CDC, about 90% of anal cancers are linked to HPV, and HPV-related anal cancer is particularly aggressive when found late. But the good news? Early detection can stop it from becoming cancer at all.
STD Test Kits offers discreet testing for high-risk HPV strains from home. Order an HPV test kit here to know if the virus is present, especially if you’re not offered anal screening by your doctor.
Anal Cancer Symptoms from HPV: What Gets Missed the Most
Let’s talk about what it actually feels like, if anything, when anal cancer starts to develop. Most HPV infections in the anal canal cause no symptoms at all. That’s why routine screening is essential. But once the cells begin to change, or if cancer is already forming, some subtle signs might appear:
Figure 1. Symptoms of anal cancer caused by HPV, and how often they get confused with everyday issues.
None of these symptoms confirm cancer. But if they persist, especially in someone with a history of HPV or receptive anal sex, testing is essential. Many people delay care because they don’t want to “overreact.” But in this case, overreacting could save your life.
Testing Before It’s Cancer: Anal Pap Smears and High-Risk HPV Screening
There is no national guideline in the U.S. for routine anal cancer screening, even among high-risk groups. That means it’s often up to you, or a really clued-in doctor, to initiate testing. But testing exists. And it works.
The main tools are:
Figure 2. Key anal cancer screening methods for early detection.
In some cities, LGBTQ+ clinics offer anal Pap testing routinely for MSM over age 35. Some HIV clinics do the same. But outside of these spaces, few providers bring it up. If you're not being offered this testing, you can ask. Or, in many cases, you can use a discreet at-home HPV test to check for high-risk strains before symptoms start.
Screening isn't just about peace of mind, it's about catching things when they’re still reversible. Because unlike many cancers, anal cancer has a known, testable, preventable cause.
What Increases Your Risk? It’s Not Always What You Think
People often assume that only people who have anal sex are at risk for HPV-related anal cancer. That’s not true. HPV spreads via skin-to-skin contact, anywhere. Here are some of the real risk escalators:
- History of cervical, vaginal, or vulvar HPV: If you’ve had HPV-related changes elsewhere, the anal canal may also be affected
- Living with HIV: Reduced immune function allows HPV to persist and cause damage
- Multiple partners and early sexual debut: More exposure routes = higher chance of HPV infection
- Smoking: Damages immune system and slows clearance of HPV
- Age over 50: Cancer development can take decades post-HPV exposure
It’s not about shame, it’s about awareness. The virus is common. What matters is how long it sticks around and how often you check in with your body (and your cells).
That’s why a discreet, accessible combo STD kit or high-risk HPV test can be the bridge between silence and survival. No appointments, no waiting rooms, just clarity, fast.
From Panic to Prevention: Ty’s Story, Revisited
After Ty’s diagnosis, he underwent surgery and chemo. The good news? It hadn’t spread. But recovery was brutal, emotionally and physically. “If I’d known I could test for this, I would’ve done it years ago,” he said. He now tells everyone in his friend group, queer, straight, women, men, to ask their doctor about anal Pap smears or order an at-home HPV test.
Anal cancer may be rare, but the path to prevention is real. And unlike some silent illnesses, this one often leaves clues, you just have to know where to look. If something feels off, or you’ve never been tested for high-risk anal HPV, this is your sign to stop wondering and start checking.
Don’t wait until symptoms force your hand. A quiet test now can change everything later.
What Happens If You Test Positive?
First of all, take a breath. A positive HPV test or an abnormal anal Pap doesn’t mean cancer. It means something is happening, and now you get to catch it early. The next steps might include:
- A repeat Pap to confirm changes
- High-resolution anoscopy (like a colposcopy, but for the anus)
- Biopsy of abnormal tissue, if needed
In most cases, if abnormal cells are found early, they can be treated or monitored before cancer develops. That’s why these tests matter, they buy you time and options.
If your result was from a home HPV test, you’ll want to follow up with a local clinic for a full exam. If you’re not sure where to go, this CDC tool can help find testing near you.
Remember: it’s not about what’s already happened. It’s about what you do next. That’s what changes outcomes.
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FAQs
1. Wait, so HPV can actually cause anal cancer?
Yeah, it can. Specifically, the high-risk strains like HPV-16 and HPV-18. They don’t cause warts. They sneak into your cells and start flipping switches that should stay off. Over time, often years, they can cause abnormal growth that turns cancerous. It’s not everyone’s fate, but it’s a real risk if the infection sticks around.
2. Is anal cancer just a “gay men” thing?
Nope. That’s a dangerous myth. While gay and bi men, especially those living with HIV, do face a higher risk, anal cancer can show up in anyone with a butthole. Women with a history of cervical HPV? At risk. People with suppressed immune systems? Also at risk. If you’ve had HPV anywhere, you could have it there too. The virus doesn’t ask about your orientation.
3. How would I even know if something’s wrong down there?
You might not. That’s the terrifying part. Early anal cancer can be completely silent. But if you do get symptoms, they’re often subtle: light bleeding when you wipe, weird pressure, an itch that won’t quit, or a feeling like you’re never quite done pooping. People write this stuff off as “just a hemorrhoid”, and that’s how it gets missed.
4. How do I test for anal HPV or cancer signs?
Two main ways: an Anal Pap smear (yep, like the cervical one) and a high-risk HPV DNA test. Some LGBTQ+ clinics offer them routinely, but you can also go the at-home route if talking to your doc feels awkward. This kit checks for high-risk strains discreetly. No stirrups. No judgment.
5. Can hemorrhoids turn into cancer?
Nope. Hemorrhoids themselves don’t turn cancerous. But, and this is key, they can look or feel like cancer symptoms. If your “hemorrhoids” bleed for weeks, or you feel a new lump, or something just doesn’t feel right? Don’t chalk it up to fiber. Get it checked. Peace of mind beats guessing games.
6. If I have HPV, will I definitely get cancer?
Definitely not. Most people clear HPV naturally in a year or two. Your immune system usually handles it. But if it sticks around, and you never screen, it can cause real damage over time. Think of it like this: HPV is common. Unchecked, long-term HPV is the issue.
7. Can I get anal cancer even if I’ve never had anal sex?
Yes. HPV spreads via skin-to-skin contact, fingers, genitals, toys, you name it. Anal sex increases risk, but it’s not required. It’s about where the virus ends up, not how it got there. So yeah, even people who’ve never had anal sex can still be at risk for anal HPV and cancer.
8. How long does it take for HPV to become cancer?
Usually years. This isn’t a fast-moving process. Most HPV infections go away. But persistent infection with the high-risk types can slowly mess with your cells. That’s why screening matters. You don’t need to panic, you need to check in.
9. Is there anything I can do to prevent anal cancer?
Yes. Get vaccinated if you’re eligible (up to age 45). Use condoms and gloves during anal play to reduce HPV transmission. Don’t smoke (it weakens your immune response). And test, early and occasionally. Prevention isn’t about paranoia. It’s about power.
10. If I test positive for high-risk HPV, what now?
Don’t freak. A positive test doesn’t mean you have cancer, it means you’ve got a risk factor. Your next steps might include an Anal Pap, a follow-up with a specialist, or simply monitoring. And if you tested from home? Follow up with a local provider to get clarity. The whole point is early action, not late regret.
You Deserve Answers, Not Assumptions
HPV is silent, common, and often misunderstood. And for some people, it doesn’t just go away. It digs in deep, where no one is looking. That’s why anal cancer linked to HPV is often caught late, especially in people who were never told they should test. But this isn’t about shame. It’s about control, clarity, and care.
If something feels off, or even if it doesn’t, it’s okay to check. It’s okay to want answers. This at-home combo test kit checks for the most common STDs, including high-risk HPV, discreetly and quickly.
How We Sourced This Article: We combined current guidance from leading medical organizations with peer-reviewed research and lived-experience reporting to make this guide practical, compassionate, and accurate. In total, around fifteen references informed the writing; below, we’ve highlighted six of the most relevant and reader-friendly sources. Every external link in this article was checked to ensure it leads to a reputable destination and opens in a new tab, so you can verify claims without losing your place.
Sources
1. Planned Parenthood: What is HPV?
2. American Cancer Society: Anal Cancer Overview
3. Basic Information about HPV and Cancer (CDC)
4. Cancers Caused by HPV (CDC)
5. Prevalence of HPV in Anal Cancer (PubMed Central)
About the Author
Dr. F. David, MD is a board-certified infectious disease specialist focused on STI prevention, diagnosis, and treatment. He is dedicated to increasing access for readers in both urban and off-grid settings by combining clinical precision with a straightforward, sex-positive approach.
Reviewed by: L. Renner, NP | Last medically reviewed: February 2026