Study reveals a hidden risk after cervical cancer

Women who have survived cervical cancer face nearly double the risk of developing anal cancer later in life compared with the general population, new research shows.

The study analysed data from more than 85,000 women diagnosed with cervical cancer and followed them over two decades to track secondary diagnoses.

Researchers at MUSC Hollings Cancer Center found the risk increased with both age and time, with the highest rates among women aged 65 to 74 who were more than 15 years beyond their first diagnosis.

At present, anal screening is recommended for certain high-risk groups, including people living with HIV, organ transplant recipients and women with a history of vulvar cancer.

No clear guidelines exist for women who have survived cervical cancer.

Ashish Deshmukh is co-leader of the cancer prevention and control research programme.

The researcher said: “We’ve known for a long time that both cervical and anal cancers are caused by HPV, the human papillomavirus.

“But what hasn’t been well-understood is how that shared risk might connect the two diseases over a woman’s lifetime.”

HPV is a common virus that can lead to several cancers, including cervical and anal. Cervical screening and HPV vaccination have made cervical cancer largely preventable, with survival rates above 90 per cent when detected early, but guidelines do not address long-term risks for survivors.

The team used the National Cancer Institute’s SEER (Surveillance, Epidemiology and End Results) programme, which tracks cancer diagnoses across the US.

For women aged 65 to 74, rates of anal cancer diagnosis exceeded thresholds typically used to recommend routine screening.

Researcher Haluk Damgacioglu, PhD said: “Our study shows that the risk doesn’t go away – it actually increases with age and over time.”

This delay occurs because HPV-related cancers can take years or decades to develop.

The virus may remain dormant or spread from another part of the body.

Deshmukh said: “It’s a slow process, and that’s part of why it’s been so hard to detect. By the time symptoms show up, the cancer is often advanced.”

Screening methods do exist, including anal cytology (similar to a cervical smear test) and anoscopy (a visual examination using a scope), but access is limited.

In South Carolina, for example, there is only one provider trained to perform high-resolution anoscopy.

“Damgacioglu said: “These results tell us that women who had cervical cancer years ago should be considered for routine anal cancer screening.

“Right now, that’s not happening.”

Deshmukh and colleagues are expanding the work with a new project to evaluate the best screening approaches for this group, in collaboration with MD Anderson Cancer Center and the Icahn School of Medicine at Mount Sinai.

The study will look at frequency and methods of screening.