A Silent Shift: Anal Cancer Rates Surge Among Older Women—Defying Long-Held Assumptions
For years, medical experts believed they had a firm grasp on who was most vulnerable to anal cancer. But new research has flipped that understanding on its head—revealing a startling demographic now at the center of a growing public health concern.
A rising wave of anal cancer cases is quietly sweeping through the United States, not among the historically highest-risk populations, but among older white and Hispanic women—a group largely overlooked in past prevention efforts.
Unexpected Spike Among Senior Women
At Digestive Disease Week (DDW) 2025, Dr. Ashley Robinson unveiled a sobering analysis from the National Cancer Institute’s SEER database (2017–2021). The data shows that women over age 65 are now experiencing the most significant increases in anal cancer, with white women seeing a rise of over 4% and Hispanic women close to 2%. In total, the rate of new cases in women aged 65 and older rose nearly 3% over the study period.
This trend runs counter to decades of medical consensus, which largely associated anal cancer with HIV-positive gay men, due to elevated rates of HPV (human papillomavirus) infection in that group.
HPV: The Common Denominator
HPV remains the leading cause of anal cancer, responsible for about 90% of cases. While certain strains of HPV cause genital warts, others are far more dangerous, triggering a range of cancers—including cervical, oropharyngeal, vulvar, and anal cancers.
The HPV vaccine, introduced in 2006, has proven highly effective. However, it is primarily recommended for preteens and young adults up to age 25. Women over 26 typically do not receive the vaccine, as they’re more likely to have already been exposed to the virus.
As a result, many women now entering their senior years were never vaccinated—leaving them vulnerable just as cancer rates among their age group begin to climb.
What’s Behind the Rise?
Though the study didn’t explore behavioral factors, experts suspect several potential contributors, including:
Aging immune systems, which may struggle to clear persistent HPV infections.
Increased longevity, exposing women to more years of risk.
Lower rates of screening for anal cancer compared to cervical or breast cancers.
Stigma or lack of awareness, leading to delayed diagnosis.
This emerging pattern has sparked calls for new screening strategies tailored specifically for older populations.
Time to Rethink Prevention and Screening
According to Dr. Robinson, it’s time to recalibrate how the healthcare system approaches anal cancer prevention. For older women—especially those not vaccinated in youth—early detection could be critical.
Possible steps forward include:
Expanding anal HPV testing for high-risk groups.
Educating older adults about the continued importance of safe s*x.
Training clinicians to look for subtle warning signs of anal cancer.
Reconsidering vaccination guidelines, especially for at-risk adults who may still benefit.
Looking Ahead: A Growing Health Threat
If current trends persist, anal cancer rates among women over 65 could double within the next 20 years. That projection is more than just a statistic—it’s a clear signal that the medical community must act now.
Public awareness campaigns, routine screenings, and enhanced provider training could help shift the tide. Most importantly, older women—often excluded from conversations around s*xual health and cancer prevention—need to be brought into the spotlight.
Final Thoughts
The rising tide of anal cancer in older white and Hispanic women is more than just a medical anomaly—it’s a wake-up call. For a disease once thought to target only a narrow segment of the population, the current data shows a much broader threat emerging. And with the majority of this at-risk group unvaccinated and under-screened, the time to revise prevention strategies is now.
By breaking outdated assumptions and adapting our health policies, we have a real opportunity to curb this growing crisis—before it becomes a full-blown epidemic.