A recent study set to be presented at Digestive Disease Week (DDW) 2025 has drawn attention to a worrying trend: a significant increase in the number of people diagnosed with anal cancer. While this form of cancer is still considered rare, the latest findings suggest that certain groups are experiencing a rapid rise in cases, raising urgent questions about prevention, awareness, and the role of vaccination.

---

What Is Anal Cancer?

According to the NHS, anal cancer develops in the anus—the opening at the end of the bowel where the digestive tract connects to the outside of the body. Unlike more common cancers such as colorectal or cervical cancer, anal cancer is relatively rare, but its impact can be serious.

The disease can begin in any part of the anal canal. Because symptoms often resemble those of less severe conditions, anal cancer is sometimes overlooked until it has progressed.

---

Symptoms and Early Warning Signs

Recognizing the signs of anal cancer is crucial, especially since the condition can be misdiagnosed as haemorrhoids or anal fissures. The most frequently reported symptoms include:

• Bleeding from the rectum or anus

• Persistent itching or pain around the anus

• Lumps inside or around the bottom

• Unusual discharge of mucus

• Changes in bowel habits, such as difficulty controlling movements

Since these symptoms can mimic other conditions, awareness among both patients and health professionals is essential for earlier detection.

---

The Study’s Key Findings

The study, conducted between 2017 and 2021, highlights concerning patterns.

“Rates of anal cancer are rising fastest among white and Hispanic women over 65 — groups not traditionally considered high risk,” said lead author Ashley Robinson, MD, a second-year internal medicine resident at Advocate Lutheran General Hospital.

Overall, anal cancer diagnoses increased by:

• 2.9% in women

• 1.6% in men

When broken down further, the highest increase was seen in white women over 65, with cases rising 4.43%. The second most affected group was Hispanic women of the same age range, with an increase of 1.7%.

These findings suggest that shifting demographic factors and gaps in vaccination coverage may be influencing the trend.

---

HPV and Its Role in Anal Cancer

Most cases of anal cancer are caused by infection with the human papillomavirus (HPV). HPV is one of the most common viruses worldwide and is typically spread through skin-to-skin contact, often during sexual activity.

Dr. Robinson emphasized that vaccination history plays a significant role in today’s rising rates:

“While the exact reasons behind this trend remain unclear, most older women were beyond the recommended age for human papillomavirus vaccination when it first became widely available.”

---

The Importance of HPV Vaccination

The HPV vaccine has proven highly effective in reducing the risk of HPV infection and related cancers, including anal, cervical, and throat cancers.

In the UK, the vaccine is routinely offered to:

• Children aged 12 to 13

• Adults over 25 who missed their earlier vaccination window

Dr. Robinson stressed the urgency of maintaining strong vaccination programs:

“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. These findings highlight specific patient groups who may benefit from targeted screening for anal HPV and anal cancer.”

---

Why Are Older Women More Affected?

The sharp rise among women over 65, particularly those who are white or Hispanic, reflects a generational gap. When the HPV vaccine first became widely available, many of today’s older adults had already aged out of the eligibility group. As a result, they carry a higher lifetime risk of HPV-related cancers.

Additionally, natural changes in the immune system with age may make it more difficult to fight off persistent HPV infections, leading to an increased risk of cancer development.

---

Current Screening Limitations

Unlike cervical cancer, where screening programs such as Pap smears are routine, anal cancer does not yet have a national screening program.

As noted by Cancer Research UK, this is largely because no test has been developed that can reliably detect anal cancer at its earliest stages. This makes prevention and symptom awareness even more critical.

---

Reducing Your Risk of Anal Cancer

While not all cases can be prevented, several steps may help lower risk:

1. Get Vaccinated
   The HPV vaccine is the most effective way to reduce the likelihood of infection. Even if someone missed the vaccine in adolescence, catch-up programs for older adults are available in many countries.

2. Practice Safer Sex
   Since HPV spreads primarily through sexual contact, using protection and limiting exposure to multiple partners can help reduce risk.

3. Quit Smoking
   Smoking is known to weaken the immune system and has been linked to higher risks of HPV-related cancers.

4. Pay Attention to Symptoms
   Unexplained bleeding, pain, or lumps should never be ignored. Seeking medical advice early may help with faster diagnosis and treatment.

5. Maintain Regular Health Checkups
   Especially for people over 65 or those in identified risk groups, routine checkups and open conversations with healthcare providers are essential.

---

The Bigger Picture: Prevention Through Awareness

Anal cancer may still be considered rare, but the steady rise in cases—especially among older women—shows that it can no longer be dismissed as a low-risk condition. Awareness campaigns, wider access to HPV vaccination, and updated screening guidelines will be crucial in addressing this growing health issue.

While scientists continue to investigate the exact reasons behind these demographic shifts, one thing remains clear: prevention through vaccination and education is our strongest defense.

---

Conclusion

The latest study presented at DDW 2025 underscores an important message: anal cancer rates are climbing in groups previously thought to be at lower risk, particularly white and Hispanic women over 65.

With no early screening tests currently available, prevention becomes the key. Expanding HPV vaccination coverage, educating both patients and healthcare providers, and encouraging prompt evaluation of symptoms are critical steps toward reducing the burden of this disease.

By staying informed and proactive, individuals and healthcare systems alike can help ensure that anal cancer is detected earlier, treated more effectively, and—most importantly—prevented whenever possible.