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Since the cause of many cases of anal cancer is unknown, it’s not possible to prevent this disease completely. But there are things you can do that might lower your risk of anal cancer.
Infection with HPV increases the risk of anal cancer. HPV infection can be present for years without causing any symptoms, so even if warts are not seen by the naked eye, that can't be used to tell if someone has HPV. Even when someone does not have warts (or any other symptom), they can still be infected with HPV and pass it on to somebody else.
Vaccines are available that protect against certain HPV infections. They protect against infection with HPV subtypes 16 and 18. Some can also protect against infections with other HPV subtypes, including some types that cause anal and genital warts.
These vaccines can only be used to help prevent HPV infection – they do not help treat an existing infection. To work best, the vaccine should be given to children at a young age before they become sexually active.
To learn more, see HPV Vaccines.
Smoking is a known risk factor for anal cancer. Stopping smoking greatly reduces the risk of developing anal cancer and many other cancers.
For people infected with HIV, it’s very important to take medicines (known as highly active antiretroviral therapy, or HAART) to help keep the HIV infection under control and prevent it from progressing to AIDS. This can also lower the risk of long-term HPV infection and anal intraepithelial neoplasia (a kind of anal pre-cancer), which might help lower the risk of anal cancer. Compared to other HIV-related cancers, the number of people with HIV who have developed anal cancer while on HAART has actually increased over the years. The reasons for this is unknown, but may be because people with HIV on HAART are living longer.
Condoms may provide some protection against HPV (and HIV), but they do not prevent infection completely. Given this, it is unclear if condom use can reduce the risk of anal cancer.
One study found that when condoms are used correctly they can lower the genital HPV infection rate in women – but they must be used every time sex occurs. This study did not look at the effect of condom use on anal HPV infection.
Condoms cannot protect completely because they do not cover every possible HPV-infected area of the body, such as skin of the genital or anal area. HPV can still be passed from one person to another by skin to skin contact with an HPV-infected area of the body that is not covered by a condom. Still, condoms may provide some protection against HPV. Male condom use also seems to help genital HPV infections clear (go away) faster.
Condom use is also important because it can help protect against AIDS and other sexually transmitted diseases that can be passed on through some body fluids.
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Bleeker MC, Hogewoning CJ, Voorhorst FJ, et al. Condom use promotes regression of human papillomavirus-associated penile lesions in male sexual partners of women with cervical intraepithelial neoplasia. Int J Cancer. 2003;107:804-810.
Centers for Disease Control and Prevention (CDC). FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59:626-629.
Centers for Disease Control and Prevention (CDC). FDA licensure of quadrivalent human papillomavirus vaccine (HPV4, Gardasil) for use in males and guidance from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59:630-632.
Czito BG, Ahmed S, Kalady MF, and Eng C. Chapter 64: Cancer of the anal region. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles & Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.
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Goodman KA, Kachnic LA, Czito BG. Chapter 76: Cancer of the anal canal. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.
Hogewoning CJ, Bleeker MC, van den Brule AJ, et al. Condom use promotes regression of cervical intraepithelial neoplasia and clearance of human papillomavirus: A randomized clinical trial. Int J Cancer. 2003;107:811-816.
Kreimer AR, Gonzalez P, Katki HA, et al. Efficacy of a bivalent HPV 16/18 vaccine against anal HPV 16/18 infection among young women: a nested analysis within the Costa Rica Vaccine Trial. Lancet Oncology. 2011 Aug 22 (epub ahead of print).
National Cancer Institute Physician Data Query (PDQ). Anal Cancer Prevention. 2020. Updated March 11, 2020. Accessed at https://www.cancer.gov/types/anal/hp/anal-prevention-pdq#_18_toc on April 7, 2020.
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Anal Carcinoma. V.1.2020. Accessed at www.nccn.org/professionals/physician_gls/pdf/anal.pdf on April 7, 2020.
Palefsky JM, Giuliano AR, Goldstone S, et al. HPV vaccine against anal HPV infection and anal intraepithelial neoplasia. N Engl J Med. 2011;365:1576-1585.
van der Snoek EM, van der Ende ME, den Hollander JC, et al. Use of highly active antiretroviral therapy is associated with lower prevalence of anal intraepithelial neoplastic lesions and lower prevalence of human papillomavirus in HIV-infected men who have sex with men. Sex Transm Dis. 2012;39:495-500.
Winer RL, Hughes JP, Feng Q, et al. Condom use and the risk of genital human papillomavirus infection in young women. N Engl J Med. 2006;354:2645-2654.
Last Revised: September 9, 2020