Dramatic Rise of Anal Cancer Cases, Deaths Sparks Concern in the US
Wed, April 21, 2021

Dramatic Rise of Anal Cancer Cases, Deaths Sparks Concern in the US

New cases of rare anal cancer are rising dramatically in the US and deaths due to the condition are "very concerning," a new study has found / Photo by: Siriluk ok via Shutterstock

 

New cases of rare anal cancer are rising dramatically in the US and deaths due to the condition are "very concerning," a new study has found.

The researchers from the University of Texas Health Science Center (UTHSC) conducted the first study that compared and categorized national trends in anal cancer cases linked to human papillomavirus (HPV). Their results, published in the Journal of the National Cancer Institute, show that anal cancer diagnoses and mortality rates have more than doubled in the last 15 years.

The study highlights one of the most relatively rare forms of cancer, as anal cancer accounts for merely two percent of all cancer diagnoses. It also sheds light on the importance of getting the HPV vaccine considering that the findings show anal cancer cases and deaths are linked to the sexually transmitted disease.

 

Tracking Diagnoses and Mortality

Anal cancer is most similar to cervical cancer, except it occurs at the end of the gastrointestinal tract and differs in the cell type. A distant-stage diagnosis of the disease means that the cancer has spread through other parts of the body and that the affected person has decreased their chances of survival.

HPV infection causes nearly 90% of these cases, usually by either of two strains of the virus. Sexually active people are at a higher risk of these two diseases since HPV has nearly 100 different types that affect 80% of people with an active sexual life.

In the UTSHC study, the researchers analyzed trends in anal cancer cases from 2001 to 2016 and found 68,809 cases and 12,111 deaths. Their analysis showed that the most common type of anal cancer rose by 2.7% a year while death rates increased by up to 3.1% during the said period.

These findings suggest that anal cancer may be among the most rapidly emerging causes of cancer incidence and deaths, MedicalXpress reports. Results also show that the prevalence was most common among older people and black men.

MedicalXpress is a web-based medical and health news service that features the most comprehensive coverage in the different fields of medicine.

"Given the historical perception that anal cancer is rare, it is often neglected," said Ashish A. Deshmukh, lead author and an assistant professor at UTHealth School of Public Health. "Our findings of the dramatic rise in incidence among black millennials and white women, rising rates of distant-stage disease, and increases in anal cancer mortality rates are very concerning."

Risks of Anal Cancer

A major risk factor for developing anal cancer is receptive anal sex, and symptoms for the disease are "fairly noticeable," according to British daily newspaper the Daily Mail.

It states that symptoms include pain, pressure, or lumps in the anal area; unusual discharge; bleeding; itching; or changes in the bowel movement. However, these symptoms could be confused with other conditions that are more common than anal cancer such as hemorrhoids.

"If people are having symptoms they should see a doctor because I think a lot of people think, 'Oh, well it's just hemorrhoids,' and don't get things checked and that could potentially also mean that you don't get diagnosed until much, much later," said Virginia Shaffer, a colorectal surgeon and associate professor in Emory University's Winship Cancer Institute who was not involved in the study.

Early and accurate diagnosis of the condition could lead to positive outcomes—with a five-year survival rate of about 80%. But that could drop to 60% once the disease spreads to the lymph nodes.

Fortunately, people can cut their risk of developing anal cancer since HPV is preventable, but the Daily Mail says merely 50% of American teens are up-to-date on their HPV vaccination. This sets them up for a potential wave of future HPV infections that could lead to cancer despite the increase in vaccination rates (5% rise from 2017 to 2018 in the US).

The British newspaper adds that, for unclear reasons, HPV infections are also on the rise. One factor could be time, given that associated cancers such as that of the anus don't develop in most people until they are of middle to old age.

A major risk factor for developing anal cancer is receptive anal sex, and symptoms for the disease are "fairly noticeable," according to British daily newspaper the Daily Mail / Photo by: Koldunov Alexey via Shutterstock

 

Preventing the Spread of the Disease

The act of receptive anal sex and the disease may lead to are still overhung by stigma. This stigma made anal cancer "pretty taboo," according to Shaffer who added that this could be "because of some of the risk factors that have historically been known to be associated with it."

This also causes patients to become hesitant to disclose the said risk factors to their doctors. Shaffer added that people who are qualified for HPV vaccination should do so in an effort to strengthen prevention initiatives, CNN reports.

Fortunately, people can cut their risk of developing anal cancer since HPV is preventable, but the Daily Mail says merely 50% of American teens are up-to-date on their HPV vaccination / Photo by: CNK02 via Shutterstock

 

For Keith Sigel, an associate professor of medicine at the Icahn School of Medicine at Mount Sinai and author of the research, the results of their study indicate the consideration of evaluating broader screening efforts—considering that screening for anal cancer is only done for certain high-risk groups.

Siegel and his co-authors urge people to get the recommended three-dose shot recommended for people 15 and older and two doses for children ages 11 to 12 with one year apart for each dose.

"It is concerning that over 75 percent of US adults do not know that HPV causes this preventable cancer," said Deshmukh. "Educational campaigns are needed to increase awareness about the rising rates of anal cancer and the importance of immunization."