A recent epidemiological analysis revealed that anal cancer incidence is increasing more rapidly among older female populations, particularly white and Hispanic women over 65 years of age.

Presented at Digestive Disease Week (DDW) 2025, the study found anal cancer increased by 2.9% for women and 1.6% for men between 2017 and 2021. Most notably, white women over 65 experienced a 4.3% increase during the 5-year study period, with incidence reaching 11.4 cases per 100,000 in 2021. Hispanic women over 65 demonstrated the second-highest rate at 7.5 cases per 100,000 for a 1.7% annual increase.

"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. "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 study utilized the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database, analyzing temporal trends in anal cancer incidence by sex, age, and ethnicity from 2017 to 2021. The researchers projected that if current trends continue, the incidence of anal cancer in women over 65 would double in less than 17 years.

HPV is implicated in approximately 90% of anal cancer cases. While current screening guidelines recommend evaluation for anal HPV, dysplasia, and cancer in immunocompromised populations—specifically individuals with HIV, bone marrow transplant recipients, and other immunosuppressed patients—the recommendations do not encompass the older female demographic identified in this study as experiencing rising incidence rates.

"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," Dr. Robinson said. "These findings highlight specific patient groups who may benefit from targeted screening for anal HPV and anal cancer."

Despite the concerning trends, anal cancer remains relatively uncommon, constituting approximately 1% of all gastrointestinal malignancies. However, the disproportionate increase among older women suggests a potential need for reconsidering current screening approaches and preventive strategies.

Source: DDW 2025