Twice as many Americans were diagnosed with and succumbed to anal cancer in 2016 as did just 15 years prior, in 2001, a new study has found.
Anal cancer is a relatively rare form of the disease, accounting for just one to two percent of all cancer diagnoses.
It’s also rarely discussed, despite the fact that actress Marcia Cross was diagnosed with the cancer and Farrah Fawcett lost her battle with it.
Nearly all cases of anal cancer are caused by human papillomavirus (HPV) – typically by either of two strains of the virus – a virus with nearly 100 different types that affect 80 percent of sexually active people.
While the dramatic rise in rates among people in their 50s and 60s discovered by University of Texas, Houston, researchers is alarming, the authors of the new study say their findings underscore the importance of getting the HPV vaccine, which can prevent many cases of the infection.
About 90% of anal cancer cases are suspected to be caused by the HPV virus (pictured in a digital rendering). Despite rising vaccinate
‘Given the historical perception that anal cancer is rare, it is often neglected,’ said Dr Ashish Deshmukh, the study’s 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.’
In 2006, the Food and Drug Administration (FDA) approved Gardasil, the first vaccine to protect against strains 6, 11, 16 and 18 of HPV.
Adoption was fairly slow at first, as it was only approved and recommended at first for women between ages nine and 26, then for all people between those ages.
As the vaccine has been incrementally approved for more and more people – now including men and women up to 45 – more people have gotten vaccinated.
Now, just over 50 percent of teenagers are estimated to be up-to-date on their HPV vaccinations, with a modest five percent increase in vaccination rates from 2017 to 2018.
Yet rates of cancers caused by HPV, which include cervical, anal, penile and head and neck cancers, have continued to climb in tandem with vaccination rates in the US.
HPV infections themselves seem to be continuing to rise, for unclear reasons.
The increase in associated cancers is likely in large part a factor of time.
WHAT IS HPV? THE INFECTION LINKED TO 99% OF CERVICAL CANCER AND 91% OF ANAL CANCER CASES
Up to eight out of 10 people will be infected with HPV in their lives
Human papilloma virus (HPV) is the name for a group of viruses that affect your skin and the moist membranes lining your body.
Spread through vaginal, anal and oral sex and skin-to-skin contact between genitals, it is extremely common.
Up to eight out of 10 people will be infected with the virus at some point in their lives.
There are more than 100 types of HPV. Around 30 of which can affect the genital area. Genital HPV infections are common and highly contagious.
Many people never show symptoms, as they can arise years after infection, and the majority of cases go away without treatment.
It can lead to genital warts, and is also known to cause cervical cancer by creating an abnormal tissue growth.
Annually, an average of 38,000 cases of HPV-related cancers are diagnosed in the US, 3,100 cases of cervical cancer in the UK and around 2,000 other cancers in men.
HPV can also cause cancers of the throat, neck, tongue, tonsils, vulva, vagina, penis or anus. It can take years for cancer to develop.
Gardasil wasn’t approved until 2006, and associated cancers don’t develop in most people until they are in their 40s to 60s.
So, many people who were exposed to the virus before the link between it and cancers was known and the vaccine was available may only just be developing those diseases.
Findings from the new study, published in the Journal of the National Cancer Institute, seem to reflect just that, plus a particularly steep rise in anal cancer rates, specifically.
Between 2001 and 106, a total of 68,809 people were diagnosed with anal cancer, and 12,111 died of the disease.
Diagnoses and deaths increased by nearly three percent each year, meaning it’s one of the fastest rising forms of cancer in the US, according to the new research.
When caught early, the prognosis for anal cancer is good, with a five-year survival rate of about 80 percent.
That drops to 60 percent once the disease spreads to the lymph nodes.
It’s symptoms are fairly noticeable – pain, pressure or lumps in the anal area, unusual discharge, bleeding or changes in bowel movements as well as itching – but they’re also easily confused with other, more common conditions like hemorrhoids.
Receptive anal sex is a major risk factor for developing anal cancer, and both the act and the cancer are still overhung by stigma, so patients may be hesitant to disclose risk factors to their doctors.
‘Screening for anal cancer is not currently performed, except in certain high-risk groups, and the results of this study suggest that evaluation of broader screening efforts should be considered,’ said senior study author Dr Keith Sigel, an associate professor of medicine at Icahn School of Medicine at Mount Sinai.
And, of course, now that the vaccine is approved for anyone 45 and under, Dr Sigel and his coauthors urge that more people get the three-dose shot regimen.
‘It is concerning that over 75 percent of US adults do not know that HPV causes this preventable cancer,’ said Dr Dshmukh.
‘Educational campaigns are needed to increase awareness about the rising rates of anal cancer and importance of immunization.’