HPV-Driven Anal Cancers in Women: A Hidden Risk

Most people know HPV as the virus behind cervical cancer, but it can also cause anal cancer, especially in women. It is often overlooked, posing a hidden risk, particularly in India, where vaccination rates and awareness need to be increased. To protect women’s health, one needs to have a thorough knowledge of the link between HPV and anal cancer, along with the benefits of HPV vaccination. 

Connection of HPV and anal cancer

Human Papillomavirus (HPV) is the most commonly transmitted infection. It causes a majority of anal cancers by certain high-risk strains of HPV, primarily HPV-16 and HPV-18. HPV can infect the anal tract, leading to precancerous changes, which might develop into invasive anal cancer without proper medical treatment. 

Risk factors in women

Females who have a history of cervical lesions or vulvar lesions are likely to develop HPV-induced anal lesions. Exposure to viral shedding and infection by other HPV-infected regions occurs because the anus is anatomically close to the vagina. Immunosuppression increases the risk, and immunosuppression is frequent with such diseases as HIV. The focus on cervical cancer ignores screening for anal cancer, which therefore postpones diagnosis. 

Vaccination benefits and guidelines

An effective initial precautionary measure against HPV-related, particularly anal cancers, is getting the HPV vaccination. The high-risk strains causing the majority of anal cancers can be prevented by the bivalent, quadrivalent, and nonavalent vaccines. Increasing the number of male and female adolescents with HPV vaccination is a must. To increase the effectiveness, guidelines suggest vaccination before the initiation of sexual activity, ideally between the ages of 9 and 14. Elderly individuals need to take a catch-up vaccination until a certain age.

Options for treatments

Combining chemotherapy and external beam radiation therapy, chemoradiation, is for the treatment of early-stage nasal cancers. Consider surgery for very early localized lesions following chemoradiation, but it can lead to severe side effects. Routine follow-up is necessary for checking its recurrence. With an immediate diagnosis and treatment, the results for  HPV-driven anal cancers can be favorable.

Rural India and raising awareness of HPV-driven anal cancers

With vast amounts of the population living in rural areas, awareness of HPV, HPV-driven anal cancers, and the advantages of vaccination is essential. Lack of information, constrained access to healthcare, and cultural sensitivities often result in late diagnosis. To encourage early detection, community health workers, regional healthcare initiatives, and educational campaigns play a crucial role in raising awareness about these diseases and promoting vaccination. This can eventually save many lives.