Anal examination (anoscopy) and biopsy

A specialist doctor examines your anus with a thin tube called an anoscope. Your doctor can take a sample of tissue (a biopsy) from any abnormal areas.

Women might have an internal examination of the vagina as well. This is because it is close to the anal canal.

Why you might have an anal examination and biopsy

You might have an anal examination and biopsy to help diagnose anal cancer. Or to find out more about the size and position of anal cancer (the stage).

Preparing for the anal examination and biopsy

It’s normal to feel anxious about this test but it usually only takes a few minutes. It might be uncomfortable but you shouldn’t feel any pain. Tell your doctor if you do.

You can ask for a man or woman doctor if you’d prefer. Or you can have someone else in the room, such as a family member.

About 10 minutes before the examination, your doctor might apply a local anaesthetic to the anal canal. This will numb the area.

What happens

Your doctor will examine the anus and the area around it with a thin tube called an anoscope. They might also examine the rectum (back passage) using a slightly longer tube. This is a proctoscopy.

You usually have these tests as an outpatient, so you can go home afterwards. The tests may be uncomfortable but are not normally painful.

You usually change into a gown before the test. You lie on your side on a bed with your knees drawn up towards your chest.

The doctor gently puts the anoscope into your back passage and some air into your bowel. The tube has a light on the end and the doctor looks for any abnormal areas.  

Your doctor might apply a liquid to the lining of the anus to help abnormal areas show up more clearly. They take samples of tissue (biopsy) from any abnormal areas. They send this to the laboratory to see if there are any cancer cells.

You should be able to go home as soon as the test is over. If you have had a biopsy, you might notice a small amount of bleeding for a day or so.

Examination under anaesthetic (EUA)

You may have this examination under a general anaesthetic. This means you're asleep during the examination. This allows your muscles to relax and makes it easier for the doctor to examine any abnormal areas. The doctor can also take tissue samples.

After your examination

You should be able to go home when the test is over and you’ve recovered from the anaesthetic.

Possible risks

Anal examination and biopsy is a safe test but there are some risks. These might include:

• discomfort after the examination

• a small tear of the skin in the anal area (perianal skin) or the most inner lining of the anal canal (mucosa)

• rubbing against or damaging a pile (haemorrhoid)

• infection after the examination but this is very rare. Speak to your doctor or specialist nurse if you have any signs of infection such as a high temperature and shivering.

Getting your results

You won't get the results at the time of the test. Any tissue samples taken are sent to the laboratory to be looked at under the microscope. You should get your results within 1 to 3 weeks.

Waiting for test results can make you anxious. Ask your doctor or nurse how long it will take to get them. Contact them if you haven’t heard anything after a couple of weeks.

You might have the contact details for a specialist nurse. You can contact them for information and support if you need to. It may help to talk to a close friend or relative about how you feel.