Anal cancer is on the rise — here's who is most at risk
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.
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4 More than 10,000 new cases of anal cancer are expected to be diagnosed in the US in 2025.
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A surprising surge
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.
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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%.
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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.
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4 The rate of anal cancer cases is rising the fastest among white women over age 65.
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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.
4 HPV infection is the leading risk factor for anal cancer.
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'It's crucial that we promote HPV vaccination as a key tool for preventing anal cancer, while also keeping health care providers informed as screening guidelines evolve,' Robinson said.
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Currently, screening for anal cancer is recommended for high risk groups — such as people with HIV, those who've had bone marrow transplants and other immunocompromised individuals — but older women aren't included.
'These findings highlight specific patient groups who may benefit from targeted screening for anal HPV and anal cancer,' Robinson said.
Rare but rising
Anal cancer is still considered rare, making up just 1% of all gastrointestinal cancers. But don't be fooled — cases in the US have been climbing steadily in recent years, along with the number of deaths.
In 2025, the American Cancer Society (ACS) predicts 10,930 new cases of anal cancer will be diagnosed, and 2,030 people will lose their lives to the disease.
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The good news: If caught early, anal cancer can often be treated successfully — and even cured — with a mix of chemotherapy, radiation and sometimes surgery, according to the Cleveland Clinic.
4 Most older women currently aren't included in routine anal cancer screening recommendations.
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However, if left untreated, the cancer can spread — and that makes it much tougher to tackle.
For instance, about 83% of people diagnosed with early-stage anal cancer are still alive five years later. But once the disease spreads to distant tissues, that survival rate plunges to just 36%, according to the ACS.
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That's why doctors and researchers are stressing the need to screen vulnerable patients and boost awareness about potential anal cancer symptoms.
Signs to look out for include bleeding from your anus or rectum, blood in your stool, pain, itching, or a growth near the anal opening.
Also, be aware of any changes in bowel movements, such as shifts in frequency or consistency, or the persistent feeling of needing to defecate.
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