Medical education curricula have historically provided limited training on communication about sensitive topics like anal health. There is limited awareness among primary care providers about anal cancer risk factors and the importance of screening in high-risk populations. Time constraints in clinical settings often lead to screening conversations being deprioritized. Stigma and embarrassment around colorectal and anal health topics affect both patients and providers, creating a mutual silence that prevents life-saving discussions. Finally, many healthcare organizations lack standardized protocols for integrating colorectal and anal cancer screening conversations into routine care for LGBTQ+ and other underserved patient communities.

Despite colorectal cancer being the second leading cause of cancer death in the United States, many healthcare providers lack specific training in initiating screening conversations with patients, particularly those from LGBTQ+ and underserved communities. Current practice often fails to address the unique barriers these populations face, including stigma around anal health discussions, lack of affirming care environments, and provider discomfort with LGBTQ+ patient populations. Additionally, many providers are unaware of the elevated risk of HPV-related anal cancer in high-risk populations, including men who have sex with men and people living with HIV. The ideal practice involves routine, affirming conversations about colorectal and anal cancer screening integrated into standard care for all eligible patients. It is imperative to promote effective collaboration between healthcare providers and community organizations to increase screening conversations and reduce cancer mortality.