Table 2.

Themes of barriers to anal self-examination (ASE)

Attitudinal barriers	Concern about discomfort with any anal examinations
	Anxiety about finding an abnormality
	Preference for a health professional to do an anal examination
	Too many sensations or sexual connotations with ASE
Knowledge barriers	Lack of awareness of anal cancer risk
	Ignorance of how anal cancer presents
Practical barriers	Inadequate physical flexibility to conduct an ASE
	Importance of cleanliness before ASE