Anal cancer cases are on the rise in the United States, with new research indicating a shift in typical patient profiles.
The findings suggest that the assumptions about demographics at high risk for this rare but serious disease, and who should be screened, may need to be reevaluated.
Amazing Surge
A study analyzed data from the National Cancer Institute covering 2017 to 2021.
Over five years, anal cancer incidences rose by 2.9% among women and 1.6% among men.
“The increase is most pronounced among white and Hispanic women over 65, who are not usually seen as at high risk,” remarked Dr. Ashley Robinson, a second-year internal medicine resident.
Specifically, the rate for white women in this age bracket rose by 4.3%, reaching 11.4 cases per 100,000 people in 2021.
Meanwhile, Hispanic women showed a slower annual increase, moving to 7.5 cases per 100,000 at a rate of 1.7% per year.
If this trend continues, the researchers project that cases among women over 65 could double over the next 17 years.
HPV Connection
While the reason behind the increased rates is unclear, Robinson has a theory. “Many older women were beyond the recommended age for the HPV vaccine when it first became widely available,” she noted.
Since almost 90% of anal cancers are associated with HPV infections, the link is hard to ignore.
HPV itself is a common virus transmitted mostly through sexual contact. While it typically resolves on its own for many, it can lead to significant cell changes for some, resulting in various cancers, including anal cancer.
The HPV vaccine was introduced widely in the U.S. in 2006, and the CDC advises adolescents and young adults up to 26 to get vaccinated before becoming sexually active.
People aged 27 to 45 who missed earlier vaccination might consider it, though their potential benefits are limited due to likely prior exposure.
Overall, the vaccine is believed to effectively prevent HPV-related cancers across several areas, including the anus.
“Promoting HPV vaccinations is crucial for preventing anal cancer, and it’s equally important to keep healthcare providers updated as screening guidelines change,” Robinson said.
Currently, screening is recommended for immunocompromised individuals, such as those with HIV or who have had bone marrow transplants, but not for older women.
“This highlights specific patient groups who might need targeted screenings for anal HPV or anal cancer,” Robinson added.
Rare, But Rising
Although anal cancer is relatively rare, accounting for about 1% of gastrointestinal cancers, its incidence—and related fatalities—has been rising steadily.
The American Cancer Society predicts that by 2025, nearly 10,930 new cases will be diagnosed in the U.S., resulting in around 2,030 deaths.
However, if detected early, anal cancer can be effectively treated through a combination of chemotherapy, radiation, and sometimes surgery.
On a brighter note, about 83% of those diagnosed with early-stage anal cancer survive for five years. In contrast, survival drops to just 36% once the disease spreads to distant tissues.
This underlines the importance of screening at-risk patients and raising awareness of anal cancer symptoms.
Key signs include rectal bleeding, blood in stool, pain or itching near the anal area, and changes in bowel habits, like altered frequency or a constant urge to defecate.
