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Anal pap smear

My doctor recommended an anal Pap smear but I’m on the fence. The test is only 26-47% accurate in picking up atypical cells according to their website. There are no universal guidelines on anal
Pap testing according to the CDC and American Cancer Society. Doctors always assume since I’m a gay man I need every screening under the sun and I don’t always agree. I use condoms, take PrEP, and get tested regularly for HIV/STIs.
1 Responses
207091 tn?1337709493
COMMUNITY LEADER
An anal pap is a decent idea. I agree that it's not terribly accurate, but if you are one of the ones in the 26-47% that it accurately finds atypical cells, you'll be glad you did it.

I agree that you don't necessarily need it simply because you're a gay man. A lot depends on your age, how many partners you've had (no judgement - just simple math, as the more partners, the higher the chance you'd be exposed to HPV), how often you bottom, if you've been vaccinated for HPV, your HIV status (if you're HIV+, I'm always going to recommend an anal pap, but you take PrEP, so I'm assuming you're neg), etc., etc.

Some docs just follow a checklist, and take nothing else into account, especially if it's covered by insurance.

It's up to you, knowing all the answers to those questions. You use condoms regularly, so your chances of getting HPV are significantly lower, though not zero. If you're younger, say 20s or younger, you can probably wait. If you're older, maybe go ahead and do it.

2 Comments
It definitely is a slippery slope. I took a look at my records and I’ve apparently been vaccinated 5 times for HPV. I don’t know how I got extra shots but I guess it doesn’t hurt. I bottom occasionally, but 90% percent of the time, I’m the top. I’m also negative. I just turned 30. Young but not that young lol. The low accuracy is enough for me to say no at this point. Their website says you can have an abnormal pap one week and a normal one next week and that the screening isn’t perfect. I think I’m going to pass for now.
I think that's fair. False positives cause a lot of anxiety, and with the noted inaccuracy of this, your overall low risk, I'd probably pass for now, too. Unless things change with your activity or you experience symptoms, maybe you can aim for it when you're 40, or something. Maybe they will have improved it by then (wishful thinking).

Good luck!
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