New Screening Recommendations for Anal Cancer Risk

Thousands of women could soon be offered screening for a less commonly discussed type of cancer, following findings from a significant study that highlighted increased risks for survivors of cervical cancer.

The study concentrated on anal cancer, which, while still considered rare, is notably on the rise among older women. It was found that those with a cervical cancer history face substantially higher risks.

Current guidelines suggest screening for specific high-risk groups, such as individuals with HIV and women who’ve had vulvar cancer. Yet, experts worry that an important demographic is being missed as anal cancer cases continue to increase.

Particularly troubling is the rise in cases among women over 65, where statistics show an approximate annual increase of 4 percent.

One notable case involves actress Farrah Fawcett, a well-known icon from the 1970s. She publicly disclosed her anal cancer diagnosis in 2006, which led to tabloid gossip regarding her personal life due to the stigma attached to the illness. Fawcett passed away in 2009, at the age of 62, after her cancer metastasized.

If current trends hold, oncologists from the US National Cancer Institute caution that the number of cases could double within the next two decades.

Research led by Dr. Haluk Damgacioglu, who specializes in disease modeling at the Medical University of South Carolina, suggests that women who have survived cervical cancer should also be classified as high risk. In the study, over 85,500 women diagnosed with cervical cancer between 1975 and 2021 were monitored for about nine years. Those who had already been diagnosed with anal cancer, or who developed it shortly after their cervical cancer diagnosis, were not included in the analysis.

Among the women studied, 64 developed anal cancer, with a noticeable increase in risk occurring 10 to 15 years following treatment. Alarmingly, nearly 60 percent of cases in the 65 to 74 age group appeared more than 15 years post-cervical cancer diagnosis. The existing threshold for screening programs is set at 17 cases per 100,000 people, and this study found rates of 17.6 per 100,000 in this demographic, indicating sufficient grounds for screening initiatives.

In the journal JAMA Network Open, Dr. Damgacioglu stated that these results underscore the need for anal cancer screening recommendations based on age and duration for women with a history of cervical cancer.

The research team advocates for more studies to evaluate the risks and benefits of such screenings and to establish the most effective age for initiating them.

Cervical cancer remains a serious threat, with approximately two women dying from it daily in the UK. Its often subtle symptoms can be confused with less severe conditions, like period pain or fatigue. Early detection increases the likelihood of surviving at least five years post-diagnosis to around 95 percent, but this figure can dramatically drop to 15 percent if diagnosed late, after metastasis occurs.

In the UK, women aged 25 to 49 are invited for cervical screening every three years. However, attendance rates are lower than desired, with only about 70 percent of eligible women seeking out their scheduled tests.

Around 1,600 individuals are diagnosed with anal cancer in the UK each year, the majority of whom are women. A well-known case in the US is that of Marcia Cross, another actress who announced her anal cancer diagnosis in 2017, linking it to an HPV strain that may have also caused her husband’s throat cancer.

Common symptoms of anal cancer can include painful lumps, changes in bowel habits, or blood from the anus, but these issues are often confused with more typical problems like hemorrhoids. Persistent or unusual symptoms should always prompt a visit to a healthcare provider.

Both cervical and anal cancers are associated with infections from high-risk strains of human papillomavirus (HPV), which is often spread through sexual contact. HPV is thought to cause over 90 percent of these cancer cases, although many types of HPV do not result in noticeable symptoms and resolve without treatment. However, in certain situations, it may lead to abnormal tissue growth, which can eventually develop into cancer.

As health officials encourage those under 25 who missed school vaccinations for cancer prevention to seek the life-saving vaccine, this newfound data might play a vital role in changing screening practices going forward.