High Resolution Anoscopy (HRA) & Anal Cancer Screening in Dublin
Specialist assessment for people who may benefit from risk-based anal cancer screening, anal high-risk HPV testing and High Resolution Anoscopy at CareBridge Medical in Dublin.
A patient-friendly pathway to help you understand recognised risk factors, what anal hrHPV testing involves, and when HRA may be considered.
Anal cancer screening is risk-based, not one-size-fits-all
Your age, HIV status, immune status, transplant history and previous HPV-related abnormalities can affect whether screening should be considered. The groups below reflect recognised risk-targeted screening principles.
Screening is generally recommended from age 35.
Screening is generally recommended from age 45.
Screening is generally recommended from age 45.
Screening is generally considered from 10 years after transplant.
Screening is generally considered within one year of that diagnosis.
Shared decision-making may be appropriate for certain HPV-related abnormalities, perianal warts, persistent cervical HPV16 or immune-related risk factors where specialist HRA access is available.
Not sure where you fit? The CareBridge risk assessment is designed to simplify recognised screening criteria. Assess your anal cancer risk →
Screening is different from investigating symptoms
Risk-based screening is intended to identify people who may benefit from assessment even when they do not have symptoms. If you have new or persistent anal bleeding, pain, a lump, changes around the anus or another concerning symptom, arrange clinical assessment rather than relying on an online screening risk assessment.
From risk assessment to anal hrHPV testing and HRA
For suitable patients, the pathway may begin by identifying recognised risk factors and can include an anal swab for high-risk human papillomavirus (hrHPV). Results help guide whether closer specialist assessment is appropriate.
Assess your risk
Identify whether you fall into a group for whom anal cancer screening is recommended or may reasonably be considered.
Anal hrHPV testing
A swab sample can be tested for high-risk HPV, including HPV16. The result can help guide whether closer assessment is needed.
High Resolution Anoscopy
When screening results or clinical circumstances meet referral criteria, HRA allows the anal canal and surrounding tissue to be examined under magnification.
If hrHPV is negative
The appropriate interval for repeat screening depends on your individual risk profile and the screening strategy used. A negative hrHPV result does not usually mean immediate HRA is required.
If hrHPV is positive
A positive result does not mean that cancer is present. Further assessment may be recommended, and anal cytology or HPV16 status can help guide the next step in some screening pathways.
What happens during High Resolution Anoscopy (HRA)?
High Resolution Anoscopy is a specialist outpatient examination that uses magnification to inspect the anal canal and perianal area in greater detail than a routine visual examination.
Practical questions before an HRA appointment
Your clinician will give you any specific preparation instructions that apply to your appointment. The points below are useful questions to clarify when booking.
Do I need to prepare beforehand?
Follow the preparation advice provided by CareBridge Medical for your individual appointment. If you are unsure, contact the clinic before attending.
How long should I allow?
Appointment length can vary depending on the assessment required and whether additional sampling is discussed.
What happens if a biopsy is needed?
If an area requires clarification, the clinician will explain why sampling is being considered and what to expect before proceeding.
When will I receive results?
If laboratory analysis is required, the clinic will explain what results are pending and the expected follow-up pathway.
A private, discreet outpatient setting
Specialist HPV and anal cancer screening conversations take place in a calm clinical environment in Kilmainham, Dublin 10.
High Resolution Anoscopy, anal HPV and anal cancer screening
Do I need a GP referral for High Resolution Anoscopy at CareBridge Medical?
No. You do not need a GP referral to book the specialist HPV, anal dysplasia or High Resolution Anoscopy service at CareBridge Medical. Patients can book directly. If you are unsure which appointment is most appropriate, contact the clinic and the team can guide you.
Who should consider anal cancer screening?
Anal cancer screening is not recommended for everyone. It is risk-targeted and may be appropriate for certain higher-risk groups depending on factors such as age, HIV status, immune status, transplant history and previous HPV-related abnormalities.
What is an anal high-risk HPV test?
An anal hrHPV test uses a swab from the anal canal to look for high-risk HPV types associated with abnormal cell changes. The result can help guide whether closer specialist assessment, including High Resolution Anoscopy, may be appropriate.
Does a positive anal HPV result mean I have anal cancer?
No. A positive high-risk HPV result means that a high-risk HPV type has been detected. It does not mean that cancer is present. Depending on the result and your overall risk profile, further assessment may be recommended.
What is High Resolution Anoscopy?
High Resolution Anoscopy, or HRA, is a specialist examination used to inspect the anal canal and surrounding area under magnification. It helps identify abnormal areas that may require closer assessment or biopsy.
Why might I need HRA?
HRA may be recommended when anal screening identifies findings that meet referral criteria, or when specialist assessment suggests that a closer magnified examination is appropriate.
Is High Resolution Anoscopy the same as a colonoscopy?
No. A colonoscopy examines the colon, while High Resolution Anoscopy is specifically designed to examine the anal canal and perianal area under magnification.
What happens during an HRA examination?
A small anoscope is used to allow examination of the anal canal, and a high-magnification colposcope is used to inspect the tissue closely. If an area looks abnormal, the clinician may discuss taking a small biopsy for laboratory analysis.
Does HRA always involve a biopsy?
No. A biopsy is not automatically required. It is taken only when an area needs further clarification. The clinician will explain what they see and whether sampling is appropriate.
What happens if anal HSIL is found?
Anal high-grade squamous intraepithelial lesion, or HSIL, is a precancerous abnormality rather than anal cancer. If HSIL is identified, the clinician will discuss the appropriate treatment and follow-up pathway.
Is screening appropriate if I have symptoms?
Screening is mainly intended for people who may be at increased risk even when they do not have symptoms. If you have persistent bleeding, pain, a lump or another concerning anal symptom, arrange clinical assessment rather than relying only on a screening questionnaire.
Can I start with the CareBridge online risk assessment?
Yes. The CareBridge risk assessment can help you understand whether recognised risk factors may apply to you before deciding whether to arrange screening or discuss your situation with a clinician.
Where is the HRA clinic?
CareBridge Medical is located at 201 Block F, Seven Oaks, Sarsfield Road, Kilmainham, Dublin 10, D10 KV70. Direct specialist booking is available without the need for a GP referral.
Clinical guidelines and evidence for anal cancer prevention, HRA and DARE
Key professional references supporting risk-based anal cancer screening, High Resolution Anoscopy, Digital Anal Rectal Examination and treatment of anal HSIL.
Consensus Guidelines for Anal Cancer Screening
The International Anal Neoplasia Society consensus guideline defines higher-risk groups, ages to begin screening, screening strategies and thresholds for referral to HRA.
View IANS screening guideline on PubMed →High Resolution Anoscopy Practice Standards
IANS practice standards describe the essential components of satisfactory HRA, clinician competencies, service standards and quality-assurance metrics.
View IANS HRA practice standards →Digital Anal Rectal Examination (DARE) Guidelines
IANS guidance sets out recommended technique and quality-assurance principles for DARE as an accessible method for earlier detection of anal cancer.
View IANS DARE guideline →Treatment of Anal HSIL to Prevent Anal Cancer
The ANCHOR phase 3 trial evaluated treatment of biopsy-proven anal high-grade squamous intraepithelial lesions in people living with HIV aged 35 years or older.
Read the ANCHOR trial in NEJM →The International Anal Neoplasia Society also provides an implementation toolkit covering screening, anal cytology, DARE, HRA referral and patient education.
Open the IANS Anal Cancer Prevention Screening Toolkit →Not sure whether you need anal cancer screening?
Use the CareBridge risk assessment to understand whether recognised factors such as age, HPV history, HIV status, immune health or transplant history may make screening relevant to you.
