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U.S. Cancer Incidence and Mortality Rise

Researchers have studied trends in anal cancer cases for approximately 15 years and have identified about 69,000 cases of anal cancer and more than 12,000 deaths during this time.

“Our findings about a sharp increase in the incidence rate among black and white women, an increase in the long-term incidence rate and an increase in mortality rates from anal cancer are very important,” said lead author of the study, Ashish Deshmuh, an assistant professor at UTHealth School of Public Health, the statement said. "Given the historical perception that anal cancer is rare, it is often neglected."

A disease in a distant stage is when the cancer has spread to other parts of the body.

Between 2001 and 2015, cases of the most common type of anal cancer increased by 2.7% per year, while deaths from anal cancer increased by 3.1% per year from 2001 to 2016.

A study published in the journal of the National Cancer Institute, "leads the numbers to a trend that seems to have been going on over the past decade," said Dr. Virginia Schaffer, a colorectal surgeon and assistant professor at Emory University's Winship Cancer Institute. “In that sense, he gives us figures of what we already expected.” Schaffer was not involved in the study.

Cancer linked to HPV

Anal cancer occurs where the digestive tract ends. It differs from colorectal or rectal cancer and is most similar to cervical cancer.

The most common subtype of anal cancer is squamous cell carcinoma caused by the human papillomavirus, known as HPV.

According to the US Centers for Disease Control and Prevention, more than 90% of anal cancer cases are associated with HPV.
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Anal cancer screening has been implemented for some high-risk groups, but the authors of the study argue that their results indicate that “broader screening efforts should be considered.” But they also believe that an increase in the number of diagnoses is unlikely to be associated with an increase in screening practice.
According to the study, there have been significant changes in the risk factors for developing anal cancer since the 1950s, including changes in sexual behavior and an increase in the number of sexual partners that increase the likelihood of HPV infection.
The emergence of the HIV epidemic, especially among men who have sex with men, could also affect the development of anal cancer, since HIV is a risk factor.
There are other risk factors, such as cervical cancer or vulvar cancer, an organ transplant, or current smoking.

Who was affected by anal cancer?

The study showed that cases of anal cancer increased significantly in people aged 50 years and older.

Perhaps this is because the recommendations for vaccination against HPV are "very narrow," Schaffer said, limiting protection for older people. When the first HPV vaccine was introduced in 2006, it was approved for people between the ages of 9 and 26, “so these older people have already gone through this break when the vaccine arrived,” Schaffer said. "This is a large number of people who missed receiving the vaccine."
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Anal cancer rates are also rising among young black men.

The authors of the study argue that HIV also disproportionately affects young black men, and the presence of HIV is a risk factor for the development of anal cancer.

The study also showed that the number of cases at a late stage is growing. In part, this may be due to the fact that HIV treatment has improved, Schaeffer said, which means that patients live longer with a weakened immune system, and by the time the diagnosis is diagnosed, the cancer can progress.

Stop stigma

There is still a stigma around anal cancer.

Desperate Housewives star Marcia Cross talked about her diagnosis of anal cancer earlier this year to help stigmatize the disease, she said.

“I know there are people who are ashamed,” Cross told CBS This Morning in June. “You have cancer. If you feel too ashamed that you did something bad because he settled in your anus?

According to Schaeffer, anal cancer has become “quite forbidden,” “I think because of some risk factors that are known to be historically associated with it.

“If people have symptoms, they should see a doctor, because I think many people think,“ Oh, well, it's just hemorrhoids, ”and they don’t check things, and it can also mean that you won’t be diagnosed before much, much later. "

Anal cancer can be prevented by vaccination against HPV. The CDC recommends two doses of the vaccine with an interval of one year for children aged 11 to 12 years in the United States. Young people under 26 can also be vaccinated. Older people should talk with their doctor, as the vaccine is most useful when administered at a younger age before a person is exposed to HPV.

To strengthen prevention efforts in the future, Schaffer said that all people who are eligible for vaccination should do so, and that the current vaccine guidelines should be examined to determine if they can be extended to other patients.

CNN's Michael Nedelman, Lisa Respers France and Sandy Lamott contributed to this report.

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