Beware that men and women can easily get anal cancer if they are so intimate

Experts pointed out that anal cancer is a lower gastrointestinal tumor with a low incidence rate. It is not an epidemic in my country. However, with the global increase in anal cancer caused by HPV infection through sexual contact, the globalization of the disease is no longer a sensational thing, and the public and even medical staff need to pay attention. Keeping the anus clean and paying attention to the hygiene of anal intercourse and other sexual contact can prevent anal cancer caused by HPV infection. The cervical cancer vaccine also has a certain preventive effect on anal cancer.

What is HPV

HPV is a group of DNA viruses that are specific to human epithelial cells and have similar morphology and genetic structure. They mainly infect human skin and mucosal epithelial cells and are closely related to the occurrence of various malignant tumors. In addition to anal cancer, the occurrence of various tumors such as cervical cancer, vulvar cancer, vaginal cancer, penile cancer, female and male genital warts, as well as head and neck squamous cell carcinoma, esophageal cancer, skin cancer, and laryngeal cancer are all closely related to the development of HPV virus.

Anal cancer suspected of HPV infection in outpatient clinic

With the increasing number of anal cancers caused by HPV infection through sexual contact, following the launch of cervical cancer prevention vaccine in 2006, the US Food and Drug Administration approved a vaccine at the end of last year for the prevention of anal cancer and precancerous lesions caused by HPV types 6, 11, 16 and 18 in people aged 9 to 26. However, the vaccination situation is not ideal. Some parents of middle school students have questioned the safety of the vaccine and are opposed to their children's vaccination; some parents believe that it is not appropriate for their children to be vaccinated because their children are too young and are considering waiting until they become adults. In addition to the United States, anal cancer caused by HPV infection has also occurred in Canada, Mexico, Australia, Europe and other places.

Professor Pan Yunlong of the Department of General Surgery at the First Affiliated Hospital of Jinan University said that "suspected" cases have also appeared in Guangzhou: "We found a mass, erosion and bleeding in the anus of an HIV (human immunodeficiency virus) positive patient, and suspected that he was infected with HPV. But unfortunately, due to financial reasons, the patient left the hospital without further examination and treatment."

HPV infection causing anal cancer is becoming the mainstream

It is reported that anal cancer in a broad sense includes anorectal cancer, anal canal cancer and anal margin cancer. The anal cancer referred to in this article refers to the latter two. The American Cancer Society estimates that approximately 5,300 people are diagnosed with anal cancer each year in the United States. Although anal cancer is not very common in the general population, its incidence is gradually increasing. Although the incidence of anal cancer is still relatively low, the incidence of this disease in men and women is increasing at a rate of about 2% per year.

"The pathogenesis of anal cancer is not yet clear, and there may be multiple causes: one is inflammation and hemorrhoids caused by bacterial stimulation. The other is that it occurs naturally with age, and similar to the formation of other tumors, genetic mutations occur in the anal area." The incidence of anal cancer is 1/100,000, and the incidence in male patients who have anal intercourse is 35/100,000.

Foreign studies show that about 90% of anal cancer is related to HPV infection. Studies have found that the types of HPV infection in the cervix and anus are highly consistent, which means that the anus and cervix have a common source of infection. Research from Taiwan shows that the pathogenic mechanism of anal cancer may be multifaceted, and it is related to HPV, Chlamydia trachomatis, smoking, chronic anal irritation, chromosomal abnormalities, etc. Additionally, anal cancer is increased in renal transplant patients.

In the United States, anal cancer occurs about equally in men and women. Studies have shown that homosexuals and those who test positive have a higher risk of anal intraepithelial neoplasia and anal cancer. Foreign studies have shown that people aged 45 and above who are infected with the HPV16 subtype are most likely to develop anal cancer; and for those who are cervical HPV positive, the risk of HPV infection in the anus is more than three times higher.

Treatment: Radiotherapy and chemotherapy gradually replace surgery

Pan Yunlong pointed out that the occurrence of anal cancer is a gradual evolutionary process. Its early lesions are anal intraepithelial neoplasia (AIN), which can develop into squamous anal cancer in the later stage. "Previous anal cancer or anal tumor,

It requires surgical removal, that is, the anus is dug out, and the patient has to carry an "artificial anus" (commonly known as a "poop bag"), which brings great inconvenience to the patient's life and affects his quality of life. "Pan Yunlong said that in the past 10 years, radiotherapy and chemotherapy have been recommended and recognized. Radiotherapy and chemotherapy can not only save the anus, but also have a good prognosis. If the effects of radiotherapy and chemotherapy are not ideal, surgical resection can be considered.

Pan Yunlong said: "Currently, anal cancer can be screened through routine anal examination combined with anoscopy. For patients who are highly suspected of anal cancer, the diseased tissue should be removed for further examination, and it is recommended that high-risk groups undergo an examination at least once a year." In the United States, anal cytology screening and anoscopy are two effective methods for detecting anal epithelial lesions (AIN). American experts recommend that people infected with HIV, men who have sex with men, and women with high-grade vulvar intraepithelial lesions, vulvar cancer, or cervical cancer need to undergo AIN screening. AIN screening is also recommended for women who engage in anal sex, those with high-grade cervical intraepithelial neoplasia, and those with visible lesions around the anus. In case of abnormal anal cytology, anoscopy should be performed further.

Prevention: Cervical cancer vaccine may prevent anal cancer

"Because the anus is moist and has a lot of secretions, the skin and mucous membranes are thin and tender and easily damaged, which can easily cause fungal and bacterial infections, and is conducive to the growth of HPV." Pan Yunlong said that HPV infection in the anus mainly comes from sexual contact. Therefore, when engaging in anal intercourse and other sexual contact, attention should be paid to hygiene and safety, especially strengthening publicity and education for young people. "Scratching the anus with hands that are infected with the HPV virus, or using contaminated towels, sheets, etc., can also cause HPV infection." Pan Yunlong pointed out that if there are symptoms such as bleeding, lumps, pain and itching in the anus, you need to go to a regular hospital for treatment in time. In addition, medical staff in hospitals also need to be vigilant about this disease, as it is easy to be overlooked due to its low incidence.