HIV and anal cancer: The good and bad news for gay men

A new study out of the Netherlands finds gay men diagnosed with HIV in recent years are less likely to get anal cancer than before.

The cancer is pretty rare among the general population: Just 1-2 people out of every 100,000 develop it every year. However, that rises to 85 out of every 100,000 HIV-positive gay men.

The Netherlands’ research looked at over 28,000 people with HIV over the past three decades. It found that gay men diagnosed with HIV since 2013 showed a 40% drop in anal cancer rates compared with those diagnosed between 1995 and 2005.

Researchers suggest this could be down to these men starting medication promptly and achieving an undetectable viral load quickly. Also, smoking has decreased in the last 20 years. Nicotine is a big anal cancer risk factor.

So, that’s the good news. The bad news is that HIV-positive women and straight men didn’t show the same decrease. Potentially, they’re not getting tested for HIV as regularly as gay men, which means they find out about their diagnosis later.

Anal cancer screening

The researchers also said that earlier screening for anal cancer would significantly boost survival rates.

In the study, around 1 in 4 of the HIV-positive gay men reported being screened for anal cancer. By comparison, only less than 1% of the women reporting screening.

In short, regularly testing for HIV is crucial. And if you’re positive, get on to medication ASAP to become undetectable.

Related: Why some gay men are getting this test to detect the early signs of a specific cancer

Besides stopping smoking, think about getting screened for anal cancer. Doctors can do an anal pap smear test or biopsy.

Just three percent of people with anal cancer died when it was picked up at an early screening. This compares to 24 percent who didn’t get screened and found out at a later stage.

Some physicians suggest an annual examination for HIV-positive men and every 2-3 years for those who are HIV-negative after the age of 50, but opinions differ.

What is anal cancer?

As its name implies, it’s cancer of your anus: that’s the hole through which many guys like to get penetrated during sex.

The majority of anal cancers are linked to human papillomavirus (HPV) infection. HPV is also linked to cancers of the cervix, penis, and throat.

Each year, around 14,000 men in the U.S. get HPV-associated cancers – the majority of these are throat-related (over 11,000), with anal cancer accounting for around 2,000 cases.

Compared to other cancers, anal cancer is rare. However, HPV infection is very common. In the U.S., it’s estimated that around 80 million adults are infected with HPV, and many will never know they have it.

Experts recommend HPV vaccination for many young people. In the U.K., gay men under the age of 45 are offered the vaccine free in sexual health clinics, whereas girls are jabbed while still in school. In the U.S., HPV vaccination policies differ from state to state.

Besides screening, don’t hesitate to seek medical advice if you notice any lumps or pain around your anus. Rectal bleeding is another common symptom of the disease.