New Research Reveals Which Women Face Highest Anal Cancer Risk—And It's Not Who You'd Expect
New research presented at Digestive Disease Week 2025 reveals a surprising shift in anal cancer trends that challenges previous assumptions about who's at highest risk. While anal cancer remains relatively rare—accounting for approximately 1% of all gastrointestinal cancers—rates are steadily increasing across the United States, with the most dramatic rises occurring among women over 65, particularly in white and Hispanic populations.
The study, led by Dr. Ashley Robinson of Advocate Lutheran General Hospital, analyzed data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database from 2017 to 2021. Researchers found that anal cancer increased by 2.9% annually for women compared to 1.6% for men during this period.
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Key Findings for Women's Health
White women over 65 experienced the most significant increase, with rates climbing 4.3% annually to reach 11.4 cases per 100,000 by 2021. Hispanic women in the same age group had the second-highest incidence, with 7.5 cases per 100,000 and an annual growth rate of 1.7%.
If these trends continue, researchers project that anal cancer incidence in women over 65 would double in less than 17 years—a concerning projection that highlights the need for increased awareness among both healthcare providers and patients.
The HPV Connection
According to the research team, approximately 90% of anal cancers are linked to human papillomavirus (HPV) infection. Dr. Robinson noted that most women now experiencing rising anal cancer rates were beyond the recommended age for HPV vaccination when it first became widely available, leaving them vulnerable to infections that may have occurred decades ago.
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"While the exact reasons behind this trend remain unclear, most older women were beyond the recommended age for human papillomavirus vaccination when it first became widely available," explained Dr. Robinson in her presentation.
Screening Gap for Older Women
Current guidelines recommend screening for anal HPV, dysplasia, and cancer only for certain high-risk groups, including individuals with HIV, bone marrow transplant recipients, and other immunocompromised populations. Notably absent from these recommendations are older women, despite the rising rates identified in this study.
This gap in screening guidelines means that many women at increasing risk may not receive early detection that could lead to better outcomes. The research team suggests that healthcare providers should consider these findings when evaluating patients who might benefit from targeted screening.
Prevention Remains Key
While these findings are concerning, Dr. Robinson emphasized that prevention through HPV vaccination remains the most effective strategy for reducing anal cancer risk in future generations. The HPV vaccine, recommended for children and young adults, protects against the strains of HPV most commonly associated with anal cancer.
"It's crucial that we promote HPV vaccination as a key tool for preventing anal cancer, while also keeping healthcare providers informed as screening guidelines evolve," she stated.
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As research continues to refine our understanding of anal cancer risk factors and demographics, experts recommend that women discuss any unusual symptoms with their healthcare providers and that parents ensure their children receive HPV vaccination at the recommended ages.
For women beyond vaccination age, awareness of symptoms and regular healthcare visits remain important protective measures as the medical community works to update screening guidelines based on this evolving understanding of who's at risk.
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