Now that actress Marcia Cross has been in remission from anal cancer for about a year, she has a mission.
“I want to help put a dent in the stigma around anal cancer,” the former Desperate Housewives star, 57, recently told People magazine. “I’ve read a lot of cancer survivor stories and many people — women, especially — were too embarrassed to say what kind of cancer they had. There is a lot of shame about it. I want it to stop.”
Cross, who was diagnosed in November 2017, is not the first celebrity to say we need to get over our squeamishness. Actress Farrah Fawcett made a documentary about her harrowing struggle before anal cancer ended her life in 2009.
But Cross is speaking out at an opportune juncture. While cancer of the anus – the short canal at the end of the rectum through which solid waste leaves the body – remains fairly rare, it has been steadily increasing for several decades, and far more women than men develop it. The American Cancer Society estimates that about 5,530 women and 2,770 men will be diagnosed this year; about 760 women and 520 men will die.
In response to this alarming trend, leading experts — specialists in oncology, pathology, gynecology, infectious diseases, and more — believe it’s time to start screening some women for anal cancer.
There are no accepted screening guidelines because, well, it’s complicated. The average woman has a tiny lifetime risk of anal cancer (two in 100,000), so figuring out which women to check, and the best way to do it, is full of dilemmas, as the experts explained in their 2016 paper, Screening for Anal Cancer in Women.
“We don’t want to spend a lot of testing resources, and create a lot of anxiety, in low-risk groups of women,” said senior author Joel M. Palefsky, an infectious disease physician and anal cancer expert at the University of California-San Francisco.
But there is something that low-risk women can do to be vigilant.
To better understand why screening all women doesn’t make sense, consider the cause of 90 percent of anal cancers: the human papillomavirus (HPV).
HPV is a ubiquitous family of sexually transmitted viruses that live in cells on the surface of the anus, cervix, vagina, vulva, penis, mouth, and throat. Although the immune system wipes out most infections with nary a symptom, persistent infection with high-risk HPV types can initiate cancer in those organs.
It should be noted that the Gardasil vaccine, recommended to be given in adolescence, prevents infection with nine high-risk types, as well as two types that cause genital warts. But the immunization remains underused – and it wasn’t available until 2006.