Symptoms and diagnosis of anal cancer


The symptoms of anal cancer can include:

  • Bleeding from your back passage
  • Small lumps around your anus
  • Pain or discomfort in the anal area
  • An abnormal discharge from your anus
  • Anal itching
  • Losing control of your bowel movements

Even though these symptoms can be caused by conditions other than cancer, do have them checked by your family doctor (GP).


Testing for cancer when you have no symptoms is called screening. There is no national anal cancer screening programme in Ireland at present. If you are worried about anal cancer, contact the National Cancer Helpline on 1800 200 700 or speak to your GP.


Visit your family doctor (GP) first if you are worried about any symptoms. Your doctor will examine you and, if concerned, will refer you to a specialist called a gastroenterologist. He or she will arrange some tests for you at the hospital. You may need some of the following tests:

Rectal exam

Stool sample to check for hidden blood

  • Proctoscopy
  • Sigmoidoscopy
  • Barium enema

Rectal exam: In this test, your doctor puts a gloved finger into your back passage to feel for any lumps or swelling. This quick test may be slightly uncomfortable but does not hurt.

Proctoscopy: In this test your doctor looks inside your back passage with a hollow metal tube called a proctoscope.

Sigmoidoscopy: A longer tube with a camera is used in this test. The tube is carefully put into your back passage and your doctor checks for any abnormal areas in the lower part of your bowel. He or she can also take samples of the cells in your bowel. This is called a biopsy.

Barium enema: This is a special X-ray of your bowel. A mixture called barium is put into your bowel and X-rays are taken. Your doctor can view your bowel as the mixture passes through it.

Other tests

  • Blood tests
  • CT scan
  • MRI scan
  • Rectal Ultrasound scan
  • PET scan

The above scans can help to stage the cancer.

Learn more about the above tests

Staging of anal cancer

The stage of cancer describes the size of your cancer and whether it has spread from its original area to other areas in the body. Knowing the stage of your cancer will help your doctor to decide on the best treatment for your cancer.

Your doctor will stage your bowel cancer using the TNM staging system. TNM refers to the size of the tumour (T), if it has spread to your lymph nodes (N), and if it has spread to other parts of your body as metastases (M). It is a complex system but it can be roughly described as the following:

Stage 1: The cancer only affects your anal area and is smaller than 2cm.

Stage 2: The cancer only affects your anal area but is bigger than 2cm.

Stage 3: The cancer has spread to nearby lymph nodes.

Stage 4: The cancer has spread to other parts of your body, for example your liver. This can also be called advanced cancer.

Call our National Cancer Helpline

Freephone 1800 200 700 to talk to a specialist cancer nurse
It's open Monday-Thursday from 9am to 7pm and Friday from 9am to 5pm