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

Richard John Hillman, J. Michael Berry-Lawhorn, Jason J. Ong, Tamzin Cuming, Mayura Nathan, Stephen Goldstone, Olivier Richel, Luis F. Barrosso, Teresa M. Darragh, Carmella Law, Céline Bouchard, Elizabeth A. Stier, Joel M. Palefsky, Naomi Jay, on behalf of the International Anal Neoplasia Society

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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.

Original languageEnglish
Pages (from-to)138-146
Number of pages9
JournalJournal of Lower Genital Tract Disease
Issue number2
Publication statusPublished - 1 Apr 2019


  • anal cancer/neoplasms
  • DARE
  • Digital Anal Rectal Examination

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