Anal cancer screening warranted for older cervical cancer survivors
By Lynda Williams, medwireNews Reporter
medwireNews: Older women with a history of cervical cancer may benefit from screening for anal cancer, research suggests.
Recognizing that screening is recommended for other patient groups with a high risk of anal cancer, such as vulval cancer survivors and those with HIV, Haluk Damgacioglu (Medical University of South Carolina, Charleston, USA) and co-workers used data from eight Surveillance, Epidemiology, and End Results registries to quantify the anal cancer incidence in cervical cancer survivors.
They collated information for 85,524 women diagnosed with cervical cancer between 1975 and 2021 and 822,630 person–years of follow-up. Sixty-four women were subsequently diagnosed with anal cancer, giving an overall incidence rate of 7.8 cases per 100,000 person–years and a standardised incidence ratio (SIR) versus the general population of 1.9.
However, the incidence rate and SIR differed according to patient age and time since diagnosis, the authors report in a research letter to JAMA Network Open.
Specifically, the incidence rate per 100,000 person–years was 2.4 for survivors younger than 45 years old and rose to 4.6 and 10.0 for women aged 45–54 and 55–64 years, respectively, before peaking at 17.6 among those aged 55–64 years, and falling to 10.0 at age 75 years and older. The corresponding SIRs were 3.5, 1.5, 1.8, 2.5 and 1.5.
The incidence rates of anal cancer for women within 5 years and 5–10 years of their cervical cancer diagnosis were 5.8 and 5.1 per 100,000 person–years, respectively. The incidence rate then increased steadily to 12.7 after 15–20 years and 16.1 after 20 years or more. The corresponding SIRs were 2.0, 1.4, 2.5 and 2.4.
Therefore, 59% of anal cancer diagnoses in survivors occurred in women aged 65–74 years at least 15 years after their cervical cancer diagnosis, say Damgacioglu and co-authors.
“This cohort study suggests that anal cancer incidence exceeds the rate of 17 cases per 100 000—a critical threshold identified for recommended screening use—among women aged 65 to 74 years with a history of cervical cancer”, the team summarises.
The authors therefore believe that their findings “support the need for age-based and duration-based anal cancer screening recommendations for woman with cervical cancer history.”
Nevertheless, Damgacioglu et al caution: “While this study provides objective data to define risk for screening eligibility, future research is important to understand screening benefits and harms and determine the optimal age to initiate screening and optimal screening intervals.
“A limitation is the lack of data on risk factors (eg, human papillomavirus infection) to help explain the association between cervical and anal cancers”, they concede.
medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2025 Springer Healthcare Ltd, part of Springer Nature
JAMA Netw Open 2025; 8: e2531362
https://pubmed.ncbi.nlm.nih.gov/40932718/
Keywords: cervical cancer, anal cancer, anal cancer screening