HPV is not only associated with cervical neoplasias and cervical cancer, it is now an established pathologic factor in other cancers including anal cancer. Anal cancer has been receiving increased attention and steadily increasing over the last 30 years and is about twice as common in women than in men. Even more worrisome, with a history of CIS and cervical cancer have a 13 fold increase rate of anal cancer. While the role and benefit of HPV testing as a screening method for anal dysplasia and anal cancer is not established or well delineated, there are some clinical operating principles that can be adopted for this developing area of women?s health.