Αρχική World News Anal Cancer Incidence and Deaths Are Rising in the United States

Anal Cancer Incidence and Deaths Are Rising in the United States

, by NCI Staff

Anal cancer cases rose 2.7% and anal cancer deaths rose 3.1% each year between 2001 and 2015.

Both the number of cases of anal cancer and deaths from the disease have been on the rise in the United States since 2001, according to a new study. The increases have been especially rapid in young African American men, as well as among all adults over the age of 50.

From 2001 to 2015, the overall incidence of anal cancer increased by 2.7% per year and mortality jumped by 3.1% each year, according to the study, published November 19 in the Journal of the National Cancer Institute.

Despite these increases, anal cancer is “still quite rare in the population,” explained Meredith Shiels, Ph.D., of NCI’s Division of Cancer Epidemiology and Genetics (DCEG), a coauthor on the study.

Most cases of anal cancer are caused by infection with human papillomavirus (HPV). A vaccine to prevent HPV infection has been available since 2006, but the cancers seen in this study reflect HPV infections acquired before the vaccine was available.

Higher vaccine uptake than has been achieved to date is needed to reverse the rise of anal cancer incidence and mortality, said Ashish Deshmukh, Ph.D., M.P.H., of the UTHealth School of Public Health in Houston, who led the study.

Trends in a Rare Cancer

To understand trends in anal cancer over the last few decades, Dr. Deshmukh and his colleagues used data on cancer incidence collected by NCI’s Surveillance, Epidemiology, and End Results (SEER) program and the CDC’s National Program of Cancer Registries (NPCR).

Cancer death data for the corresponding period came from the National Center for Health Statistics. The researchers also looked at changes in incidence over time among groups defined by sex, race, age, and year of birth.

Between 2001 and 2015, they found, almost 70,000 people in the United States received a diagnosis of anal cancer. The majority were female, white, and over the age of 50. But some groups had an even greater increase in risk. For example, adjusting for age, the risk of anal cancer among young African American men born around the mid-1980s was five times higher than that in African American men born in the late 1940s.

“This finding was particularly sobering, because these men are very young” compared with the age range of people typically diagnosed with anal cancer, said Dr. Deshmukh. This high incidence, he said, is likely driven by the higher rate of human immunodeficiency virus (HIV) infection among younger black men in the United States. HIV weakens the body’s ability to fight off HPV infection.

In addition to the overall rising incidence, the number of cases of anal cancer diagnosed at a later stage—when the cancer had already spread to nearby or distant parts of the body—also increased between 2001 and 2015. During this time period, diagnoses involving advanced disease tripled in men and more than doubled in women.

These rising rates of advanced-stage disease likely underly the increases seen in deaths from the disease, particularly in older adults, noted the authors. For example, they saw a nearly 5% increase in deaths from anal cancer per year in people aged 60 to 69.

A Viral Trigger

HPV is a group of more than 200 related viruses, some of which are spread through vaginal, anal, or oral sex. Most of these viruses do not cause cancer. But about 14 sexually transmitted HPV types are known to cause six types of cancer: cervical cancer, oropharyngeal (throat) cancer, and anal, penile, vaginal, and vulvar cancers.

Two types, HPV16 and HPV18, are responsible for most HPV-caused cancers. Even if someone is infected with one of these viruses, though, the immune system can usually eliminate the infection. But in some people, the infection persists, and infected cells eventually become cancerous. This risk that an infection will persist is higher in people with weaker immune systems, including older adults and people living with HIV.

It takes about two decades or more for HPV infection to lead to cancer, explained Dr. Deshmukh. This means that cases of anal cancer observed in the study would be related to HPV infections contracted in the 1990s or earlier, before a vaccine to prevent infection with cancer-causing HPV types was available.

Screening and treatment of precancerous changes in the cervix caused by HPV have reduced the incidence of cervical cancer in women aged 50 and older by 65% since the 1970s. But to date, no screening method has been shown to reduce the risk of anal cancer, said Dr. Shiels.

The rising incidence of anal cancer has been on researchers’ radars for some time, even if the extent of the increase wasn’t highlighted until now. Some efforts have already begun to test screening strategies for some of the populations at highest risk, Dr. Shiels said.

For example, an NCI-funded clinical trial called ANCHOR is currently testing whether treatment of precancerous anal lesions can prevent the development of anal cancer in men and women with HIV.

Even with the rising incidence over the last two decades, “only about 8,000 cases of anal cancer are diagnosed in the United States each year,” said Dr. Shiels. “Examining screening in this highest-risk population makes sense at this time.”

Hard Conversations

In the absence of evidence of effective screening tests, like the Pap and HPV tests for cervical cancer, to prevent the incidence of anal cancer from continuing to rise in the future, “emphasis should be on rapidly scaling up HPV vaccination rates,” said Dr. Deshmukh.

Many barriers have kept US HPV vaccination rates around 50% in the recommended age groups, with significant variation between states. One barrier is that many people still don’t know that HPV causes cancer. In a study published earlier this year, Dr. Deshmukh and his colleagues found that fewer than 30% of adults surveyed knew that HPV could cause anal, oral, and penile cancers. And a substantial number of young adults didn’t even know that the virus causes cervical cancer.

To improve HPV vaccination rates, better communication between health care professionals, people eligible for the vaccine, and their families is crucial, said Dr. Deshmukh. Those discussions should be driven by the CDC’s most recent recommendations on HPV vaccination.

But in the earlier study conducted by Dr. Deshmukh and his team, only about 20% of vaccine-eligible men and about 30% of vaccine-eligible women or people with vaccine-eligible family members had ever received a recommendation for HPV vaccination from their doctor. Overcoming physicians’ reluctance to recommend the HPV vaccine “has great potential” to improve its use, he said.

There is also a need for more awareness and less stigma around anal cancer, explained Haisar E. Dao, M.D., of the University of Texas Health Science Center at San Antonio, who was not involved with the study.

“People think that anal cancer only occurs in people who are immunosuppressed, or have HIV, or who are men who have sex with men,” Dr. Dao said. “And although these populations are more at risk of anal cancer, it’s not exclusive to these population.”

Symptoms of anal cancer can include bleeding, pain in the anal region, and swelling or lumps in the area. “Anyone with symptoms should be seen by a specialist as soon as possible,” he added.

Such conversations require overcoming taboo and embarrassment, Dr. Dao explained. “People don’t want to talk about any anal or rectal conditions. But it’s important not to minimize any [of these] symptoms.”

People often think that these symptoms must be caused by hemorrhoids and can be ignored, added Dr. Dao. And while that’s a likely explanation, “a few times we’ve found very advanced cancers that could have been caught earlier,” he said.

And earlier diagnosis can be important, Dr. Deshmukh stressed. “[Mortality] can often be avoided if we diagnose anal cancer early.”



Συμπληρώστε το email σας για να λαμβάνετε τις σημαντικότερες ειδήσεις από το ogkologos.com

Βρείτε μας

2,449ΥποστηρικτέςΚάντε Like

Διαβαστε Επίσης

Καρκίνος και Κορωνοϊός (COVID-19) ΜΕΡΟΣ Α

Εάν είστε καρκινοπαθής, το ανοσοποιητικό σας σύστημα μπορεί να μην είναι τόσο ισχυρό όσο κανονικά, έτσι μπορεί να ανησυχείτε για τους κινδύνους που σχετίζονται...


Η Παγκόσμια Ημέρα Κατά του Καρκίνου καθιερώθηκε με πρωτοβουλία της Διεθνούς Ένωσης κατά του Καρκίνου (UICC), που εκπροσωπεί 800 οργανώσεις σε 155 χώρες του...


ΕΞΕΛΙΞΕΙΣ ΣΤΗ ΘΕΡΑΠΕΙΑ ΤΟΥ ΜΗ-ΜΙΚΡΟΚΥΤΤΑΡΙΚΟΥ ΚΑΡΚΙΝΟΥ ΤΟΥ ΠΝΕΥΜΟΝΑ (ΜΜΚΠ) Γράφει ο Δρ Παπαδούρης Σάββας, Παθόλογος-Ογκολόγος   Ο ΜΜΚΠ βρίσκεται αναλογικά στο 80% και πλέον του συνολικού...

Διατρέχουν όντως οι καρκινοπαθείς μεγαλύτερο κίνδυνο λόγω κοροναϊού;

Σε πρακτικό επίπεδο, τα δεδομένα των σχετικών μελετών υποδηλώνουν ότι η χημειοθεραπεία ή οι άλλες αντι-νεοπλασματικές θεραπείες δεν αυξάνουν σημαντικά τον κίνδυνο θνησιμότητας από...

FDA: Η ακτινοβολία των smartphones δεν προκαλεί καρκίνο

Σε μια νέα έκθεσή της, η Υπηρεσία Τροφίμων και Φαρμάκων (FDA) των ΗΠΑ αναφέρει ότι επανεξέτασε τις σχετικές επιστημονικές έρευνες που δημοσιεύθηκαν τα τελευταία...

Νέα ανακάλυψη, νέα ελπίδα για τον καρκίνο

Ένα νεοανακαλυφθέν τμήμα του ανοσοποιητικού μας συστήματος θα μπορούσε να αξιοποιηθεί για την αντιμετώπιση όλων των ειδών καρκίνου, σύμφωνα με επιστήμονες του πανεπιστημίου Cardiff...
- Advertisment -

Ροή Ειδήσεων

FDA Approves Pembrolizumab Combination for the First-Line Treatment of Cervical Cancer

On 13 October 2021, the US Food and Drug Administration (FDA) approved pembrolizumab (Keytruda, Merck) in combination with chemotherapy, with or without bevacizumab, for...

From Scan to Scan: The Challenges of Living with Metastatic Cancer

October 15, 2021, by NCI Staff Bethany Ross has been living with metastatic neuroendocrine cancer since she was diagnosed in 2018. Credit: Used with permission from...

The award-winning researcher behind next generation sequencing

Next generation sequencing (NGS) has given the genomic research community ultra-high throughput, scalability, and speed that could only be dreamed of 20 years ago....

Many Breast Cancer Patients Use Cannabis to Manage Symptoms But Don’t Tell Their Doctors

Cancer and cancer treatment come with many side effects, including nausea, vomiting, and pain. In addition to the physical toll, the impacts to a...

Medicare Open Enrollment Starts Tomorrow!

Medicare open enrollment is upon us for 2022. If you are a Medicare recipient, this is the time of year when you can make...

Cancer in My Community: Providing Supportive Care in Serbia

Cancer in My Community is a Cancer.Net Blog series that shows the global impact of cancer and how people work to care for those with...