Health Advice: How Common Is Anal Cancer?

Farrah Fawcett's death shook me. How common is anal cancer in women, and how can I know if I'm at risk?

Deborah K. Armstrong: Although anal cancer is a relatively rare cancer, the incidence is increasing. There are about 5,000 cases of anal cancer per year in the United States, about 2,000 in men and about 3,000 in women, so it is more common in women than men. Anal cancer has been associated with human papillomavirus (HPV) infection, which is likely sexually transmitted via receptive anal intercourse. The risk of anal cancer is also increased for immunosuppressed individuals; those with a history of other HPV-associated cancers, such as cervical or vulvar cancer; and smokers.

The anal region has the sphincter muscles that are critical for continence. Thus, surgical removal of all but the smallest anal cancers will require a colostomy. For this reason, a combination of chemotherapy and radiation is more commonly used to treat localized anal cancers. Because of the association between anal cancer and other cancers, such as tonsillar cancer, with HPV infection, it is expected that the incidence of these cancers may decrease with the use of HPV vaccines. HPV vaccination is approved by the Food and Drug Administration for females ages 9 to 26 and was recently approved in males ages 9 to 26 as well.

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