Wrong direction.

This sobering analysis of US cancer statistics reveals an increase in both anal cancer incidence and mortality. A deeper look showed this was nearly ubiquitous across the country but most concentrated in Southern and Midwestern states that saw sharp increases in incidence (>1.5-fold for men and >2-fold for women) and mortality (>2-fold for both men and women over age 50). This appears to be correlated to incidence of HIV among men and smoking among women. In fact, rates of anal cancer among women are now astoundingly comparable to cervical cancer in 12 states. While upstream measures such as smoking cessation, regular condom use and HPV vaccination are ideal, the authors of an accompanying editorial pose the interesting question of whether anal Pap smears with early identification and treatment of anal HSIL could move the needle. | Damgacioglu, J Clin Oncol 2023 & Hotca, J Clin Oncol 2023