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Anal cancer sometimes spreads to nearby lymph nodes (bean-sized collections of immune system cells). Swollen lymph nodes in the groin can be a sign that cancer has spread. Biopsies may be needed to check for cancer spread to nearby lymph nodes. Far less common than colorectal cancer, anal cancer affects about one in 500 people in their lifetime versus one in 22 people. The number of anal cancer cases has been steadily growing for years. Only a small number of anal cancers spread, but when they do, the disease is difficult to treat. Md andersons colorectal center treats more patients with anal cancer than most other cancer centers in the nation with customized treatment plans. Anal cancer can be detected by direct rectal exam or anoscopy, without colonoscopy. Would a colonoscopy detect anal cancer? Also could anal cancer develop within 8 months after a perfectly clean colonoscopy? Cancer worry your concern about anal cancer indicates the need for you to see your doctor. Anal cancer arises from the cells around the anal opening or in the anal canal just inside the anal opening. Anal cancers arise from skin cells and are called squamous cell carcinomas. Cells that are becoming malignant but have not invaded deep to the skin are referred to as high grade dysplasia, carcinoma-in-situ or bowens disease. David usually before the colonoscopy, the doctor performs a finger rectal exam to examine the anus. David anal cancers can be felt with the finger and they almost always bleed. Anal cancer is an uncommon malignancy that starts in the anus-- the opening at the end of the rectum. The american society of clinical oncology estimates that 8,300 cases of anal cancer will be.