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(CNN) - Cases of anal cancer and deaths are increasing dramatically in the United States, especially among older people and young black men, according to a new study.
The researchers examined trends in anal cancer cases for approximately 15 years and identified around 69,000 cases of anal cancer and more than 12,000 deaths during this time.
"Our findings about the dramatic increase in incidence among black millennials and white women, the increase in disease rates in distant stages and increases in death rates from anal cancer are very worrying," the statement said in a statement. lead author of the study, Ashish A. Deshmukh, assistant professor at UTHealth School of Public Health. "Given the historical perception that anal cancer is rare, it is often neglected."
Distant stage disease is when the cancer has spread to other parts of the body.
From 2001 to 2015, cases of the most common type of anal cancer increased 2.7% per year, while mortality rates from anal cancer increased 3.1% per year from 2001 to 2016.
The study, published in the Journal of the National Cancer Institute , "gives figures to a trend that seems to be happening in the last decade," said Dr. Virginia Shaffer, a colorectal surgeon and associate professor at the University Winship Cancer Institute at Emory "In that sense, it gives us numbers of what we were already waiting for." Shaffer did not participate in the study.
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HPV related cancer
Anal cancer occurs where the digestive tract ends. It is different from colon or rectal cancer and is more similar to cervical cancer.
The most common subtype of anal cancer is squamous cell carcinoma, caused by the human papillomavirus, known as HPV.
More than 90% of cases of anal cancers are associated with HPV, according to the Centers for Disease Control and Prevention. UU. (CDC).
Anal cancer screening has been implemented for some high-risk groups, but the study authors argue that their findings suggest that "broader screening efforts should be considered." But they also believe that the increase in diagnoses is probably not due to an increase in screening practices.
Since the 1950s, there have been substantial changes in risk factors for anal cancer, including changes in sexual behaviors and a greater number of sexual partners, according to the study, which increase the likelihood of contracting HPV.
The emergence of the HIV epidemic, especially among men who have sex with men, may also have influenced anal cancer trends because HIV is a risk factor.
There are also other risk factors, such as having had cervical or vulvar cancer, having received an organ transplant or being a current smoker.
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Who is affected by anal cancer?
The study found that anal cancer cases have increased significantly in people 50 years of age or older.
It may be because the HPV vaccine guidelines are "very strict," Shaffer said, limiting protection for older adults. When the first HPV vaccine was introduced in 2006, it was approved for people between the ages of 9 and 26, "so these older adults exceeded that limit when the vaccine came out," Shaffer said. "That's a lot of people who missed the vaccine."
Anal cancer rates are also rising among young black men.
HIV also disproportionately affects young black men, the study authors said, and having HIV is a risk factor for anal cancer.
The study also found that the number of advanced cases is increasing. This could be partly because the treatment for HIV has improved, Shaffer said, which means that patients live longer with compromised immune systems and that the cancer may have progressed further at the time of diagnosis.
Stop stigma
There is still stigma around anal cancer.
Marcia Cross, star of “Desperate Housewives,” spoke about her diagnosis of anal cancer earlier this year to help stigmatize the disease, she said.
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"I know there are people who are ashamed," Cross told "CBS This Morning" in June. "You have cancer. Should you feel ashamed of having done something wrong because it settled in your anus? ”
Anal cancer has become "quite taboo," Shaffer said, "I think because of some of the risk factors that have historically been associated with it."
"If people have symptoms, they should see a doctor because I think a lot of people think, 'Oh, well, they are just hemorrhoids,' and things are not controlled and that could mean they won't diagnose you until much, much later." .
Anal cancer can be prevented by vaccination against HPV. The CDC recommends two doses of the vaccine one year apart for children 11 to 12 years in the US. UU. You can also vaccinate young adults up to 26 years old; Three doses are recommended for people 15 years of age or older.
The vaccine is most beneficial when administered at earlier ages, before a person is exposed to HPV, but the CDC says that adults between 27 and 45 who have not been vaccinated properly can make a decision with their doctors about the HPV vaccine. It is not recommended to do so for those over 45 years of age who have not been vaccinated, since HPV vaccines are not licensed for use in that age group.
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To strengthen prevention efforts in the future, Shaffer said that all people who qualify for vaccination should do so, and that current vaccine guidelines should be studied to determine if they can expand to other patients.
Michael Nedelman, Lisa Respers France and Sandee LaMotte of CNN contributed to this report.
Cancer