Dying of Embarrassment
Anal cancer is less common than many other cancers, but only about half of anal cancers are detected early, when they are most treatable.
Why? Because people don't talk to their doctors about it.
Partly for this reason, only about 67% of people diagnosed with anal cancer survive five or more years. Unlike cervical cancer, which has dropped dramatically since the advent of the Pap smear, anal cancer is on the rise. Incidence rates over the past three decades have jumped by 78% in women and 160% in men. Being HIV positive, as well as having unprotected sex, raises one's risk. Also, men or women can be at risk for anal cancer even if they've never had anal sex.
Like cervical cancer, anal cancer is predominantly caused by the sexually transmitted human papillomavirus (HPV). Lisa Flowers, professor of gynecology and obstetrics, is Emory's principal investigator (PI) for ANCHORstudy, a clinical trial to help determine whether screening and treatment of precancerous areas of the anus can prevent cancer.
"The lesions that can cause anal cancer are found in at least half of HIV infected men and 20% of HIV infected women. These lesions have no symptoms," she says. "We know that for women, treating lesions on the cervix can prevent cancer, so we're hopeful that treating these lesions in the anus will also prevent cancer. But this hasn't been proven yet, so most doctors in the U.S. don't screen for it or treat it."
Emory hopes to enlist 340 participants out of the 5,058 HIV-positive men and women 35 years and older being recruited at multiple sites for the study.
"No one knew that cervical cancer was preventable before screening and treatment of precancerous cells became widespread in the 1960s and cut the incidence of the disease by 75%," says Joel Palefsky, clinical trial PI at University of California, San Francisco.
Perhaps the same can be done for anal cancer. The first step, say researchers, is being able to talk about it.
For more information, go to ANCHORstudy.org/emory or call 404-251-8931.
