Midwest and Southeast Experience Dramatic Increase in Anal Cancer

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Anal cancer is a type of cancer that affects the tissues of the anus, the opening at the end of the rectum. It is a rare type of cancer, but its incidence has increased in recent years.

According to a study recently published in Journal of Clinical Oncology, South Carolina, is one of the states with the most significant increases in female anal cancer incidence and male anal cancer deaths. The study was led by his Dr. Ashish Deshmukh, the following investigator. MUSC Hollings Cancer Center.

In a recent study, Deshmukh identified state-level incidence patterns, disease frequencies, mortality patterns, and associations between HIV/AIDS and smoking as potential explanations for increased anal cancer incidence and mortality. Did. He recently joined the Medical College of South Carolina as co-leader of Hollings’ cancer management program. His research focuses on understanding cancer incidence and mortality, estimating the impact of risk factors on cancer, and identifying effective cancer prevention strategies and algorithms.

Ashish Deshmukh

Dr. Ashish Deshmukh is investigating the incidence of cancer caused by HPV.Credit: Clif Rhodes/MUSC Hollings Cancer Center

Deshmukh’s current publication is Journal of the National Cancer Institute, national anal cancer trends were quantified for the first time. He documented a dramatic rise in human papillomavirus (HPV)-associated anal cancer incidence, advanced disease, and mortality.

“Anal cancer is often neglected and stigmatized, and has historically been recognized as a rare malignancy,” says Dr. Schmidt, citing the dramatic increase in disease incidence and mortality seen in the United States. Deshmukh, who is trying to change public perceptions, said: About 10,000 new cases and more than 1,600 of her deaths are expected to be attributed to anal cancer in 2022.

After detecting the alarming rise in anal cancer incidence and mortality from 2001 to 2015, the next goal is to understand where and why the incidence is rising. bottom. Using the National Cancer Statistics and National Center for Health Statistics data sets of 88,159 anal cancer cases and 14,483 deaths in all 50 US states, Washington, DC, and Puerto Rico, the researchers compared data from 2014 to 2018. We estimated anal cancer incidence and mortality for each state by year. 2001–2005, in relation to HIV and smoking.

His team found that across the United States, anal cancer incidence and mortality increased 1.5-fold in men and women over the age of 50. However, the most notable increase – more than doubling – occurred among people over the age of 50 living in Midwestern and Southeastern states. In South Carolina, the incidence of anal cancer in women doubled from 2001 to 2005 and the death rate in men tripled from 2014 to 2018.

The paper also identifies the main factors leading to an increase in anal cancer among men and women. In states where HIV was more common, the incidence of anal cancer was higher among men. State-level incidence patterns correlated with smoking among women. “HIV infection enhances the carcinogenic effects of HPV and leads to more rapid anal cancer development. Our study suggests that smoking may also be an important risk factor for anal cancer in women.” ,” he added Deshmukh.

In some states, HIV-infected individuals are now screened for anal cancer, generally at large medical centers. Currently, anal cancer screening lacks the underlying infrastructure and support for other successful screening programs such as cervical cancer. For example, South Carolina has only two facilities that do anal cancer screening, both in Charleston, one of which is at her MUSC Health Women’s Health. “These significant challenges need to be overcome to ensure effective implementation of screening for equitable cancer prevention and closing inequalities,” she said.

Over 90% of anal cancers are associated with HPV infection. HPV vaccination has the potential to eradicate nearly all anal cancers in the future, emphasizing the importance of rapidly improving her HPV vaccination coverage among targeted adolescents. increase. However, the vast majority of people with significantly increased rates of anal cancer, those over the age of 50, are not eligible for the vaccine. Vaccines are generally recommended for people up to age 26, but can be given to people up to age 45. Personal factors ensure that. This age gap heightens the importance of identifying new screening approaches that could be widely implemented and adopted, Deshmukh said.

Deshmukh’s ongoing research will shed more light on this challenge and help health care providers and policy makers improve guidelines for anal cancer screening. “To date, HPV vaccination is the best way to prevent six cancers, including cervical, vaginal, vulvar, penile, anal and throat cancers. . Hollings HPV vaccination vehicle Reaching rural and underserved communities is a key asset for the state,” said Deshmukh.

Reference: “State variation in anal squamous cell carcinoma incidence and mortality in the United States and its association with HIV/AIDS and smoking,” Haluk Damgacioglu, Ph.D., Yueh-Yun Lin, MS, Ana Patricia Ortiz, Ph.D., MPH, Chi-Fang Wu, Ph.D., Zahed Shahmoradi, Ph.D., Shiang Shiuan Syu, MS, Ruosha Li, Ph.D., Alan G. Nyitray, Ph.D., Keith Sigel , MD, Ph.D., MPH, Gary M. Clifford, Ph.D., Naomi Jay, NP, Ph.D., Vivian Colon Lopez, Ph.D., Gregory M. Barnell, NP, MS, Elizabeth Y. Chiao, MD, MPH, Elizabeth A. Stier, MD, Karen J. Ortiz-Ortiz, DrPH, Jeslie M. Ramos-Cartagena, MS, Kalyani Sonawane, Ph.D. and Ashish A. Deshmukh, Ph.D. , MPH, 28 November 2022, Journal of Clinical Oncology.
DOI: 10.1200/JCO.22.01390

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