Anal Cancer on the Rise in U.S., but Easily Preventable

By Dr. Mahesh Karamchandani, colon and rectal surgeon at Bronson Colon & Rectal Surgery Specialists

Although not one of the more common types of cancer, anal cancer accounts for one to two percent of all intestinal cancers. According to The American Cancer Society, it is estimated that this year:

• There will be approximately 8,600 new cases of anal cancer (5,900 women and 2,700 men).
• Anal cancer will cause approximately 1,350 deaths (810 in women and 540 in men).

What is anal cancer, and who is at risk?

Anal cancer forms in the anal canal – the end of the large intestine, below the rectum, where solid waste leaves the body.

The risk of developing anal cancer is relatively low – approximately 1 in 500. In comparison, the risk of developing colorectal cancer is approximately 1 in 22. Women are at a slightly higher risk than men, and it is most common in adults between 55 and 64 years old.

Rising anal cancer rates in certain populations

According to a study published by the Journal of National Cancer Institute, the number of cases of squamous cell cancer – the most common form of anal cancer – increased 2.7% each year between 2001 and 2015. The number of deaths due to anal cancer increased 3.1% each year during the same time frame.

According to a study published by the Journal of National Cancer Institute, young African-American men and adults over the age of 50 account for the highest increase in anal cancer diagnosis from 2001-2015. In fact, the risk of anal cancer in African-American men born in the mid-1980s is five times higher than African-American men born in the late 1940s.

The risk of anal cancer doubled among white men and women born after 1960. During this period, the number of anal cancer cases diagnosed in more advanced stages also increased threefold in men and doubled in women.

HPV and anal cancer

According to the Centers for Disease Control (CDC), the human papillomavirus (HPV) causes around 90 percent of all anal cancer cases. It takes HPV two to three decades to cause anal cancer. This is one reason that anal cancer is more common in older adults who didn’t have access to the HPV vaccine as children.

As HPV is linked to anal cancer, as well as many other types of cancer, getting vaccinated is extremely important. HPV vaccination rates, however, remain low. The HPV vaccine works best when given to children. The CDC recommends two doses of the vaccine, one year apart, for children ages 11-12, or three doses for anyone age 15 and older.

Adults between the ages of 27 and 45 can talk with their primary care provider to decide if getting the vaccine is a good option for them. The vaccine is not approved for anyone over age 45.

Risk factors and warning signs

Aside from HPV, other anal cancer risk factors are:

• Having anal sex or multiple sexual partners
• Having a weakened immune system (having the HIV infection, undergoing chemotherapy or taking immunosuppressive drugs)
• A history of prior radiation treatment to the area
• Smoking cigarettes

If you experience any of the following symptoms, talk with your doctor right away:

• Bloody stool, or bleeding from the anus or rectum
• Pain or itching near the anus
• A mass or growth in the anal canal

Screening and treatment

Most cases of anal cancer have high cure rates, especially if diagnosed early. Unfortunately, diagnosis is often delayed, as there is still a taboo associated with HPV. Also, symptoms can be confused with less dangerous health concerns like hemorrhoids.

Those who are already infected with HPV can reduce their risk of developing anal cancer, or can catch it early if it does develop, by receiving regular screenings to look for precancerous changes.

Once diagnosed, anal cancer is typically treated with combination of chemotherapy and radiation. Five years after treatment is complete, 70 to 90 percent of patients are alive and disease free.

Although anal cancer is a rare form of cancer, rates are rising faster than many other types of cancer. To put yourself at a lower risk, be sure to:

• Practice safe sex to help prevent HPV and HIV, two causes of anal cancer.
• Get vaccinated, preferably as a child, and screened regularly as an adult.
• Stop smoking.

High-Quality Cancer Care Close to Home

If you receive a cancer diagnosis, trust southwest Michigan’s most preferred healthcare system. Bronson Cancer Centers - located in Battle Creek and Kalamazoo - offer a comprehensive approach to care that surrounds with the expertise, technology, resources and positivity that you and your family need for your cancer journey. Learn more about Bronson's regional cancer program, including our nationally-recognized center in Battle Creek, at bronsonhealth.com/cancer.

If you need a referral to a specialist for a colon or rectal concern, ask your primary care provider to refer you to a Bronson oncologist or colon & rectal provider. Meet our colon and rectal providers here, and meet our cancer providers here.