Anal canal cancer in Brazil: why should we pay more attention to the epidemiology of this rare disease?

Mauro Ds Donadio,Rachel P Riechelmann

doi:10.3332/ecancer.2020.1037

Abstract

Anal canal cancer is one of the human papilloma virus (HPV)-associated diseases with increasing incidence. High-risk sexual behaviour and the resurgence of human immunodeficiency virus (HIV) infection, associated with low HPV vaccine coverage, are risk factors for the increased incidence of this cancer. In this paper, the authors point out pertinent questions regarding the greater exposure of the population to some risk factors and discuss the latest epidemiological data of these factors, particularly those of concern to emerging countries like Brazil. The authors also discuss policies adopted that have not been successful to combat the HIV and HPV rise and that have direct consequences on the incidence of anal canal cancer.

Highlights

Introduction and backgroundSquamous cell carcinoma of the anal canal, often broadly termed anal canal cancer, is a rare disease but its frequency is increasing, especially in high-risk groups [1]
An ongoing Brazilian study to determine the prevalence of human papilloma virus (HPV) in sexually active women and men aged 16 to 25 years and to investigate regional differences in prevalence and virus types showed that for 5.812 women and 1.774 men analysed with median age of 20.6 years, 17.7% of the study participants reported the presence of a previous sexually transmitted diseases (STDs) or tested positive for the rapid human immunodeficiency virus (HIV) or syphilis tests
Parents who accepted the HPV vaccine for their daughters but not for their boys were more likely to ignore that the vaccine is recommended for boys

Summary

Introduction and background

Squamous cell carcinoma of the anal canal, often broadly termed anal canal cancer, is a rare disease but its frequency is increasing, especially in high-risk groups [1]. The study showed that risky sexual behaviour was observed in 83.4% of respondents, with the average of sexual partners in the last year being 2.2 (95% CI 1.7–2.7), and the average of sexual partners in the last 5 years being 7.5 (95% CI 4.5–10.6) [11] Because it is a strongly HPV-related disease, most (approximately 85%) of anal canal cancers are of squamous cell origin [6]. We will discuss some pertinent and worrying aspects on the increasing incidence of anal cancer in Brazil which may apply to other emerging countries

Discussion

Findings

Conclusion

Funding source