293 Receptive Anal Sex in Women and Risk of Colorectal Cancer (2009–2014): A Retrospective Analysis of NHANES

Abstract

INTRODUCTION: Risk factors for early presentation of colorectal cancer is a topic of particular current interest. Prevalence of receptive anal sex has not been well researched, although some studies suggest that it is increasingly popular. The objective of the current study is to examine if there is an increased risk for colorectal cancer in women who engage in receptive anal intercourse as compared to patients who have not engaged in receptive anal sex. METHODS: The National Health and Nutrition Examination Survey (NHANES) was considered for women who answered the sexual health questionnaire (SXQ) during the survey cycles that included a SXQ item referring to anal sex (2009–2014). The questionnaire assessed sexual health behaviors including history of receptive anal intercourse in women. Additional NHANES data was matched for demographics, including race, as well as medical diagnoses, such as colorectal cancer and HPV infection. Statistical analysis was conducted using the statistical software, R. RESULTS: A total of 7,781 women completed the NHANES SXQ between 2009 and 2014 but only 6,596 answered the question mentioning receptive anal intercourse. A total of 2,203 women (28.3%), stated that they had a history of receptive anal intercourse at least once. The rate of reported history of receptive anal intercourse did not significantly increase across the 3 cycles: 2009–2010 (789, 29.0%) to 2013–2014 (782, 29.6%). From 2009 to 2014, there were a total of 19 participants (0.29%) with a diagnosis of colorectal cancer, with 5 patients who had both a diagnosis of colorectal cancer and history of anal intercourse. The risk of a diagnosis of colorectal cancer with a history of receptive anal intercourse in women was 0.0023, whereas the risk of a diagnosis of colorectal cancer with no history of receptive anal intercourse was 0.0032. There was no significant evidence that receptive anal intercourse in women is associated with risk of colorectal cancer. There was insufficient data for concurrent HPV infection and CRC in those without a history of anal sex, thus we are unable to test for significant difference between risk of CRC for women with HPV as compared to women without HPV. CONCLUSION: Results from the questionnaire did not suggest an increasing trend of receptive anal intercourse from 2009 to 2014. No significant difference was found in relative risk of diagnosis of colorectal cancer in women who engaged in anal intercourse as compared to those who did not engage in anal intercourse.