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But pain and bleeding can also be a symptom of anal cancer—a much less common condition but one that people may worry about more. Called anal cytology, this procedure involves taking and analyzing samples of cells from the anal canal to look for pre-cancerous anal lesions. If at any time you are feeling strong pain then you should stop immediately. If lesions are found, you will be enrolled and randomized to either have the lesions treated or monitored every six months. During a screening visit, you will be screened for pre-cancerous anal lesions. These include going slowly, working your way up to penetration with the penis with smaller objects such as fingers or sex toys, and using a lot of water-based lubrication. Oil-based lubricants such as lotion and moisturiser can weaken condoms and make them more likely to break.