 There is no standard screening protocol for anal cancer even as disease incidence and mortality increases; however, a digital anorectal exam also called a digital rectal exam will play a role in any recommended protocol. Critically, fewer digital anorectal exams are being performed by physicians even though it is a simple and quick procedure. If men who have sex with men MSM can learn to examine the anal canal, then detection and treatment of early cancers among this population may increase. This single-visit Phase II feasibility study will investigate increasing digital anal exam DAE use to enhance screening for anal cancer among MSM aged 27-80 years. The investigators hypothesize that MSMs DAE findings will have moderate or substantial agreement with a nurse practitioner DAE for detecting an anal abnormality defined as condylomas, hemorrhoids, fissures, and malignant tumors. As a secondary hypothesis the investigators believe a partner-assisted DAE conducted within a couple will have better agreement with the nurse practitioner DAE than will a self-DAE conducted by a single person. It is not proposed that lay persons recognize specific conditions but, rather, that any abnormality should trigger a doctor visit. The specific aims are: 