ANAL CANCER DIAGNOSES AND DEATHS rose dramatically in recent years. A study published in the Nov. 19, 2019, Journal of the National Cancer Institute found that rates of anal cancer diagnoses and deaths due to the disease grew about 3% annually from 2001 to 2015-2016, making it one of the fastest growing cancers in terms of incidence and mortality rates. The study analyzed data from all U.S. cancer registries, covering 99% of the population.
Annual increases in anal cancer diagnoses were highest among adults over the age of 50 with distant-stage disease. The annual increases in incidence of distance-stage anal cancer rose 8.6% per year for men and 7.5% per year for women. Mortality rates due to anal cancer rose 4.9% annually for adults in their 60s.
Most American adults don’t know that the human papillomavirus (HPV) causes most anal cancers, according to a research letter published Sept. 16, 2019, in JAMA Pediatrics. Better awareness could save lives, as anal cancer is curable if caught early and is often preventable via HPV vaccination if given before the recipient is infected.
“Ninety percent of Americans who develop anal cancer had an HPV infection at some point,” says Keith Sigel, an infectious disease specialist at the Mount Sinai Icahn School of Medicine in New York City and senior author of the study. “Older adults likely have a higher risk because they were not vaccinated against HPV, and there are no standard guidelines for screening [for anal cancer].”
HPV is the most common sexually transmitted disease in the U.S. Nearly all sexually active adults are infected at some point in their lives, and the virus can remain dormant for years. “HPV spreads through any genital contact with an infected person,” says Cathy Eng, a medical oncologist at the Vanderbilt-Ingram Cancer Center in Nashville, Tennessee, who was not involved with the study. Risk factors for anal cancer include having multiple sexual partners, a history of any sexually transmitted infections, an abnormal Pap test, a history of smoking or a compromised immune system, Eng says.
Signs and Symptoms of Anal Cancer
Bleeding from the rectum is often the first sign of anal cancer, but there may be no symptoms.
According to the American Cancer Society, signs and symptoms of anal cancer may include:
- rectal bleeding;
- rectal itching;
- a lump at the anal opening;
- pain or a feeling of fullness in the anus;
- narrowing of the stool or other bowel movement changes;
- abnormal discharge from the anus; or
- swollen lymph nodes in the anus or groin.
If you notice any of these signs or symptoms, speak to your doctor.
The Advisory Committee of Immunization Practices recommends HPV vaccination at the age of 11 or 12 to prevent infection before potential exposure to the virus. It is not recommended over the age of 26, but adults ages 27 to 45 may decide to get vaccinated based on a discussion with their doctor. The HPV vaccine protects against types of HPV that cause anal cancers and also cancers of the cervix, vulva, vagina, penis and back of the throat.
“Our study results suggest that screening [for anal cancer] should be strongly considered,” Sigel says. “We also need to boost HPV vaccination rates to prevent more cancers from occurring.”
In the U.S., there will be an estimated 8,590 new diagnoses of anal cancer in 2020 and an estimated 1,350 deaths from the disease in 2020. “Anal cancer is easy for doctors to find with a digital rectal exam,” says Eng. “When caught early, it is highly curable with a five-week course of combined chemotherapy and radiation, avoiding the need for surgery and a permanent colostomy.”
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