ANAL CANCER IS ON THE RISE
ANAL CANCER IS ON THE RISE, ESPECIALLY AMONG CERTAIN WHITE WOMEN AND YOUNG BLACK MEN. OVER 15 YEARS, INCIDENCE INCREASED 2.7% ANNUALLY AND MORTALITY RATES INCREASED 3.1% PER YEAR.
Anal cancer incidence and deaths are on the rise, especially among millennial black men and certain white women, according to new research.
The study, published Tuesday in the Journal of the National Cancer Institute, looked at trends in squamous cell carcinoma of the anus (SCCA) — the most common type of anal cancer — between 2001 and 2016. It found that during that stretch, incidence increased 2.7% annually and mortality rates increased 3.1% per year.
“Anal cancer may be one of the most rapidly accelerating causes of cancer incidence and mortality in the U.S.,” lead study author Ashish Deshmukh, an assistant professor at the UTHealth School of Public Health in Houston. “That’s very concerning.”
Anal cancer is less common than many other types of cancer, making up about 0.5% of all new U.S. cancer cases, according to the National Cancer Institute (NCI). Common risk factors include human papillomavirus (HPV); being older than 50; having many sex partners; engaging in receptive anal sex; a history of cervical, vaginal or vulvar cancer; and medicines or conditions that suppress the immune system, including HIV, the Mayo Clinic says.
Standard treatment typically includes radiation therapy and chemotherapy, according to the NCI. The five-year survival rate for cases that are localized (confined to the primary site) is 82%, but lower for regional cases (spread to the nearby lymph nodes) and distant-stage cases (spread to distant parts of the body).
Black men born around the mid-1980s had an almost five-times-higher risk of being diagnosed with anal cancer as those born in the mid-1940s, the present study found. Among white women and white men born post-1960, diagnoses more than doubled.
“If increasing SCCA incidence trends continue in older women and cervical cancer incidence continues to decline,” the authors added, “SCCA may surpass cervical cancer over the next 10 to 15 years to become the leading HPV-associated cancer in elderly U.S. women.”
What’s more, the share of people diagnosed with distant-stage SCCA has doubled suggesting that the increased incidence isn’t simply attributable to increased screening, Deshmukh said.
Why the rise in incidence and mortality, particularly among these specific groups? Deshmukh speculated that a few factors could be at play: Black Americans are disproportionately impacted by HIV, which is a risk factor for anal cancer. An increase in risky sexual behaviors during the 1960s sexual revolution and the normalization of anal sex could have played roles, he said.
The average lifetime cancer-related cost for anal cancer patients 66 years and older was $50,150 in 2014 dollars, according to previous research co-authored by Deshmukh.
“Although the prevalence of anal cancer among the elderly in the United States is small, its economic burden is considerable,” he and his co-authors wrote.
Deshmukh urged the public to take preventive steps against anal cancer: The Centers for Disease Control and Prevention recommend the HPV vaccine for all boys and girls at ages 11 to 12, though they also endorse catch-up vaccinations for anyone through age 26. The Gardasil 9 HPV vaccine is FDA-approved for adults aged 27 through 45, though the CDC advises making that decision with a doctor’s input.
Individuals at high risk for anal cancer — including those who are HIV-positive, men who have sex with men, women who have had cervical cancer and organ transplant recipients — may want to consider a screening, Deshmukh added.
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