Haluk Damgacioglu, PhD, discusses cervical cancer's link to anal cancer risk

In a recent interview with Contemporary OB/GYN, Haluk Damgacioglu, PhD, assistant professor at the Medical University of South Carolina, discussed his findings about the link between cervical cancer and future anal cancer risk.^1,2

Anal cancer remains rare in the general US population, with incidence rates of approximately 1.2 per 100,000 in men and 2.4 per 100,000 in women. However, certain high-risk groups, including people with HIV, vulvar cancer survivors, and women with a history of cervical cancer, face significantly higher risks.

Current guidelines from the International Anal Neoplasia Society and the CDC recommend screening primarily for individuals with HIV, but there is limited clarity on whether and how other high-risk populations should be screened. A key barrier is the lack of widespread availability of high-resolution anoscopy (HRA), the standard confirmatory test for anal cancer, which is resource-intensive and not easily accessible across the United States.

Damgacioglu and his colleagues conducted one of the first large-scale epidemiologic studies to specifically assess the link between cervical cancer history and anal cancer risk. Their findings indicate that women with prior cervical cancer diagnoses, particularly those diagnosed 10 to 15 years earlier and currently aged 65 to 74 years, have a significantly greater risk of developing anal cancer.

The study reported incidence rates exceeding 17 cases per 100,000 person-years, a threshold used by international societies to justify screening. These results suggest that women with cervical cancer history meet criteria that warrant further investigation into targeted screening strategies.

Although the study did not explore biological mechanisms, the authors note that both cervical and anal cancers are associated with human papillomavirus (HPV). Coinfection with cervical and anal HPV strains is common, providing a plausible explanation for the elevated anal cancer risk in this population. However, more research is needed to establish a causal link.

These findings have potential implications for US screening policy. While the United States Preventive Services Task Force has not yet issued anal cancer screening guidelines, the results may serve as an important signal to investigate further.

Large-scale randomized clinical trials are unlikely because of the rarity of the disease. Instead, mathematical modeling will likely play a critical role. Models can simulate the natural history of HPV-related cancers, compare screening algorithms, and evaluate cost-effectiveness, mortality impact, and quality-adjusted life years gained.

Damgacioglu and his mentor, Ashish Deshmukh, PhD, are currently involved in projects developing such models. Their work could provide the evidence base needed for national recommendations, particularly regarding whether women with a history of cervical cancer should be included in anal cancer screening protocols.

No relevant disclosures.

References

1. New study reveals a hidden risk after cervical cancer. Medical University of South Carolina. September 11, 2025. Accessed September 11, 2025. https://www.eurekalert.org/news-releases/1097373?
2. Damgacioglu H, Curtis C, Sonawane K, et al. Anal cancer incidence among women with a history of cervical cancer by age and time since diagnosis. JAMA Network Open, 2025;8(9). doi:jamanetworkopen.2025.31362