Anal cancer is on the rise — here’s who is most at risk

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Talk about a pain in the butt.

The number of anal cancer cases in the US is rising, and a new study suggests the typical patient profile is changing.

Researchers say the findings challenge assumptions about which demographics are considered high-risk for the rare yet deadly disease — and who should be getting screened for it.

In the study, researchers analyzed data from the National Cancer Institute from 2017 to 2021.

Over the five-year period, they found that anal cancer increased by 2.9% for women and 1.6% for men.

“Rates of anal cancer are rising fastest among white and Hispanic women over 65 — groups not traditionally considered high risk,” said lead author Dr. Ashley Robinson, a second-year internal medicine resident at Advocate Lutheran General Hospital.

White women over 65 saw the most significant spike, with a 4.3% increase over the five-year period, reaching 11.4 cases per 100,000 people in 2021.

Hispanic women in the same age group weren’t far behind, with 7.5 cases per 100,000 and a more gradual annual increase of 1.7%.

If this trend continues, researchers said the number of anal cancer cases in women over 65 could double in less than 17 years.

The HPV connection

The reason why anal cancer rates are increasing among older women remains unclear, but Robinson has a theory.

“Most older women were beyond the recommended age for human papillomavirus (HPV) vaccination when it first became widely available,” she explained.

With about 90% of anal cancers tied to HPV infections, that potential link is tough to overlook.

HPV is a common virus typically passed through sexual contact. For most people, it causes no issues and goes away on its own. But for some, it causes cell changes that can lead to a variety of cancers, including those of the anus, according to the Mayo Clinic.

The HPV vaccine became widely available in the US in 2006. The CDC recommends that adolescents and young adults up to age 26 get the vaccine — ideally before they become sexually active.

While some older adults between 27 and 45 may consider getting vaccinated if they missed it earlier, the benefits are more limited since they’ve likely already been exposed to HPV.

The vaccine is considered highly effective at preventing HPV infections and related cancers, including those of the vagina, vulva, penis, anus, mouth, throat and neck.

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