Anal cancer
This page provides information about anal cancer, its symptoms, and why it is particularly relevant for people living with HIV.
Anal cancer is a rare type of cancer that affects the anus. In the UK, around 1,500 people are diagnosed each year.
The anus connects your bowel to the outside of your body (your bottom) and anal cancer can start in any part of the anus.
Symptoms of anal cancer may include:
- Bleeding from your bottom or blood in your poo
- Persistent pain or itching around the anus
- Small lumps, bumps, growths, or skin changes near the anus
- Mucus discharge from your bottom
- Needing to poo more often or looser bowel movements
- A feeling of not fully emptying your bowels.
For more information on the symptoms, diagnosis and treatment, visit: NHS Anal Cancer
Who is at risk?
Most anal cancers are caused by human papillomavirus (HPV), but it is important to remember most people with HPV will not develop cancer.
You may be at higher risk for anal cancer if you:
- Have anal sex
- Are over 75 years old
- Smoke
- Have had cervical, vaginal or vulval cancer
- Have a weakened immune system, such as from HIV.
Finding cancer early makes it much easier to treat successfully.
Checking for changes yourself
Knowing what's normal for you is important. Gently feeling the area around your anus (for example, after a shower) can help you notice any new lumps, bumps, or changes in the skin.
If you find anything that wasn't there before, it's important to get it checked by your clinic.
People living with HIV
Though rare, people living with HIV are approximately 19 times more likely to be diagnosed with anal cancer than the general population.
Around 90% of anal cancer cases are linked to HPV infection. For people living with HIV, the virus can weaken the immune system, making it harder for the body to clear the HPV infection, and therefore increasing the risk.
Getting tested for anal cancer
You should contact your GP practice if you notice a change that is not normal for you.
A clinician will normally perform a physical examination of your anus and back passage. They might also give you a simple home test called a FIT (Faecal Immunochemical Test), which looks for tiny amounts of blood in your poo, that are too small to see. This test can help to spot cancer before symptoms even show.
You can do this yourself at home by collecting a very small sample of poo on a collection stick and putting it in a sample tube. These are available at all HIV and Sexual Health clinics across Cheshire and Merseyside.
Reducing risk
You cannot always prevent anal cancer, but a HPV vaccination is one of the best ways to protect yourself.
It helps protect against cancers caused by HPV, as well as genital warts.
The HPV vaccine is recommended for high-risk groups, including:
- People living with HIV.
- Men aged 45 years old and under who have sex with men.
- Trans men and trans women aged 45 years old and under, if their risk of getting HPV is the same as men who have sex with men.
- Sex workers.
There are also healthy changes you can make to lower your chances of getting anal cancer, including:
- Use condoms during sex to lower your risk of getting HPV.
- Keep sex toys clean and do not share them.
- Try to quit smoking.
Bottom Line charity
Bottom Line was formed by people with lived experience of anal cancer, and their voices are at the heart of all they do. Their friendly online support group is a place you can share your story, hear how others are living with the disease or just chat about the day-to-day experience of living, or caring for someone, with anal cancer. To visit, please click here.
CMCA's anal cancer awareness campaigns
In 2024, Cheshire and Merseyside Cancer Alliance (CMCA) began studying the experiences of people living with HIV when accessing cancer care. The findings highlighted ways to improve awareness of cancer symptoms and prevention within the HIV community.
This led to two collaborative campaigns:
A partnership with BHA for Equality to share anal cancer information with Black communities. BHA for Equality is a Manchester-based organisation that support people from Black and Minority Ethnic communities in improving their health and well-being. They’re experts in engaging the community and have a strong background in sexual health promotion, HIV prevention and cancer awareness.
Launching in January 2026, a partnership with George House Trust to raise awareness of anal cancer symptoms among men who have sex with men (MSM). George House Trust is a leading HIV charity in the UK, with a long history of supporting people living with HIV across the Northwest. They are committed to tackling stigma and empowering people to make informed decisions about their health. A link to the campaign will be available here as soon as it is live.