To determine whether it is hemorrhoids or cancer (perianal cancer), it can be identified based on a combination of symptoms, signs and laboratory and imaging tests. 1. Symptoms: Hemorrhoids usually bleed after bowel movement, usually fresh blood covering the surface of stool; cancer, there may be fresh blood, mucus, pus and blood, etc. In addition to local manifestations of cancer, there may also be systemic manifestations such as anemia, emaciation and cachexia. 2. Physical signs: anal fingerprinting is an important means to distinguish hemorrhoids and cancer. Hemorrhoids are softer to touch, and at the same time, they are in the form of vascular mass; cancerous lesions may have ulcers on the surface, and the necrotic tissue at the bottom of the ulcers is grayish-white to the naked eye, and at the same time, some of the cancerous lesions are harder to touch. 3. Laboratory: blood liver and kidney function can be used to understand the patient’s general condition, and to check whether the patient has HPV and HIV at the same time. 4. Imaging: anoscopy and proctoscopy play an important role in the initial assessment of lesions; imaging can determine whether there is distant metastasis, and pathology is the gold standard of detection. If abnormalities are found, it is recommended to seek medical attention as soon as possible to improve the examination, make a clear diagnosis, and cooperate with the doctor for treatment if necessary.