International Anal Neoplasia Society Guidelines for the Practice of Digital Anal Rectal Examination

J Low Genit Tract Dis. 2019 Apr;23(2):138-146. doi: 10.1097/LGT.0000000000000458.


Objective: The aim of the study was to develop recommended techniques and quality assurance metrics for the practice of Digital Anal Rectal Examination (DARE).

Materials and methods: The International Anal Neoplasia Society undertook a literature review and, using the AGREE II technique, developed guidelines for performing DARE.

Results: A consensus was formed regarding the optimum conditions and characteristics of DARE. Several Quality Assurance metrics were developed.

Conclusions: Digital Anal Rectal Examination is a cheap and potentially universally available technique, which has the potential to facilitate the early diagnosis of anal cancers, when they are most amenable to treatment. These guidelines provide a basis for teaching the technique and may be used as for evaluation research.

Publication types

  • Review

MeSH terms

  • Anus Neoplasms / diagnosis*
  • Diagnostic Tests, Routine / methods*
  • Early Diagnosis
  • Humans
  • Image Processing, Computer-Assisted / methods*
  • Optical Imaging / methods*
  • Practice Guidelines as Topic
  • Quality Assurance, Health Care