Jennifer Byrne , 2025-05-06 20:00:00
Key takeaways:
- White and Hispanic women aged 65 years and older had the most pronounced increases in anal cancer incidence from 2017 to 2021.
- Researchers encourage a “higher index of suspicion” when evaluating these patients.
SAN DIEGO — Anal cancer incidence is on the rise in the United States, with the most pronounced increases among older white and Hispanic women, according to research presented at Digestive Disease Week.
These findings question assumptions about which groups should be deemed high-risk and screened for anal cancer.
“The most important conclusion from this research is that there are populations outside of the known high-risk patient populations that have increasingly high rates of anal cancer,” Ashley Robinson, DO, a second-year internal medicine resident at Advocate Lutheran General Hospital, told Healio. “Within the two groups, white and Hispanic women over 65, we are seeing the most rapid increases with an estimated doubling time of around 16 to 17 years in white women, meaning that in that time, we expect the rate to go from around 11 per 100,000 to 22 per 100,000 if the trends continue in the same direction they have been.”
Anal cancer comprises 1% of all gastrointestinal cancers, with more than 90% of anal cancers caused by chronic HPV infection, according to study background.
Immunocompromised patients, including those with HIV infection or recipients of bone marrow transplants, should be screened for anal HPV, anal dysplasia and cancer.
“In previous research, it has been noted that women over the age of 65 have rates that were increasing more than other groups,” Robinson told Healio. “We wanted to further characterize these findings, looking into more specific details of these previously noted trends.”
Robinson and colleagues conducted an analysis of sex- and age-specific trends in anal cancer incidence from 2017 to 2021, including differences between ethnic groups, using the National Cancer Institute’s Surveillance, Epidemiology and End Results, or SEER, database.
The researchers found that among all ethnic groups, the annual percent change in anal cancer incidence between 2017 and 2021 was 2.9% (95% CI, 2.5%-3.4%) in women and 1.6% (95% CI, 1.1%-2.2%) in men.
The rise in incidence among women predominantly affected white women, mostly those older than 65 years, a group that reached 11.4 cases per 100,000 (95% CI, 10.7-12) in 2021. The 5-year annual percent change among white women aged 65 years and older was 4.3% (95% CI, 3.4%-6.8%). Researchers estimated incidence would double in 16.8 years if this trend continues.
Hispanic women aged 65 years and older demonstrated the second highest incidence in 2021 — 7.5 cases per 100,000 (95% CI, 6.3-8.9), with a 5-year annual percent change of 1.7% (95% CI, 0.7-2.8%).
Black women aged 65 years and older had a 2021 incidence of 6.3 cases per 100,000, with a 5-year annual percent change of 1.2% (95% CI, 0.1%-2.5%).
Robinson said these findings identified a population of patients who may potentially benefit from anal cancer screening in the future.
“There are some guidelines for anal cancer screening in certain at-risk patient populations, such as those with HIV, solid organ transplant patients or women who have a history of vulvar or vaginal cancer, but no specific guidelines for those who fall outside those specific categories,” Robinson said. “These findings may suggest that women, especially white and Hispanic women over the age of 65, may also benefit from anal cancer screening.”
She also urged clinicians to follow current screening guidelines and to have a “higher index of suspicion” for anal cancer in patients who fall within these groups.
“Further research would need to be done to determine if screening for HPV, anal dysplasia and anal cancer has more positive impact than negative in this patient population,” Robinson added.
For more information:
Ashley Robinson, DO, can be reached at ashley.robinson2@aah.org.
Sources/Disclosures
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Robinson, A, et al. Analysis of temporal trends in anal cancer incidence by sex, age and ethnicity, 2017-2021. Presented at: Digestive Disease Week; May 3-6, 2025; San Diego.
Disclosures:
Robinson reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.
