One of the biggest risks for anal cancer is the assumptions made about who gets it and how it’s caused.
Most of us assume the risk for anal cancer is something to do with sex, more specifically anal sex. The reality is, anyone who is sexually active, men, women as well as trans and gender diverse people, are at risk of anal cancer.
If you’ve been following our recent discussion on HPV (Human Papillomavirus), you’d know that HPV is a silent, symptom-free sexually transmitted infection (STI) that 80% of sexually active people already have, that’s the pre-curser to anal cancer. The majority of us won’t know we’ve got it and usually it clears itself without treatment.
Some strains of HPV can lead to pre-cancerous or cancerous lesions in various parts of the body, if the virus is not cleared by the immune system. The most common cancers that HPV causes are cervical, anal, vaginal, vulvar, penile, and mouth and throat cancers.
In Australia, even with some of the best healthcare in the world, some groups of people have less access to appropriate diagnosis, treatment and care than others. One group is women, particularly women living with HIV, especially when it comes to anal cancer.
As a woman, I didn’t expect to hear that I was at risk of anal cancer, and I was surprised to hear that HPV affects anyone who is sexually active! While the rate of anal cancer is unacceptably high in gay, bisexual and other men who have sex with men living with HIV, women are also at risk of anal cancer due to HPV or the Human Papillomavirus.
In 2018, Positive Life conducted an anonymous survey of women and, trans and gender diverse (TGD) people with cervixes living with and without HIV, to find out their knowledge and experience of HPV and HPV-related cancers. We wanted to learn more about the ways that we can support people to know their HPV-related cancer risk and improve their health outcomes, as well as improve prevention, diagnosis, treatment and support services. The community report can be read here.
One of the themes that came out of the survey report is that while cervical screenings among women and, TGD people in Australia is reasonably high, this is not the case for anal cancer screenings. Even when people have treatments for other kinds of HPV-related cancers, such as cervical, vaginal or vulvar cancer, none had ever screened for anal cancer.
So why is this happening, when we know that those who have had other HPV-related cancers, as well as those who have HIV or are otherwise immunocompromised, are at a significantly greater risk of developing anal cancer?
We think one piece of this puzzle is asking our medical practitioners to start talking about anal cancer and begin the conversation about screening for anal cancer and other HPV-related cancers, in comfortable and non-judgemental ways with us. If we can make this a standard of best practice in medical care, we can change the way the healthcare system works with and for women and, TGD people throughout NSW and Australia.
Another important part of the puzzle is to up skill and empower all of us to start talking about these topics with our healthcare providers, friends and family ourselves. Whenever we talk openly about these kinds of things, over time they become more normalised and less stigmatised, while also raising awareness among others.
Who knows if having a casual conversation with a friend about anal cancer could end up saving their life?
When we’re informed, we’re empowered, and that empowerment ripples outwards to others around us. Let’s start having these conversations and talk with our healthcare practitioners. Let’s get tested for HPV-related cancers, including an anal cancer screen if recommended by your doctor, so we’re in the driver’s seat of our health.
If you have any questions about anal cancer or your risk, or if you want to talk to a peer also living with HIV, contact Positive Life on (02) 8357 8386 or 1800 245 677 (freecall) or email contact@positivelife.org.au.
