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Expert Q&A

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Does my orientation boost my risk for rectal cancer?

Asked by Nathan Lancaster, Jacksonville, Florida

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I am at risk of rectal cancer because of my orientation and not able to find reliable info. Where can I go to actually get the true information about this? And where can I go to get free publications? Any info would be great, as I am hearing that this is on the rise.

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Conditions Expert Dr. Otis Brawley Chief Medical Officer,
American Cancer Society

Expert answer

Dear NL,

Cancer of the colon and rectum is the fourth-leading cause of cancer in the U.S. and Western Europe. These cancers are due to family history, diet and reasons unknown. The American Cancer Society recommends that all men and women over age 50 and those at increased risk because of family history of early cancer or inflammatory bowel disease get screened.

Those with a family history and adults over age 50 with the technology available should get a colonoscopy. It should be repeated every 10 years if normal. Annual stool blood testing with or without sigmoidoscopy (visual scoping of the lower bowel) and other tests are also reasonable.

Anal cancer is a very different disease from rectal cancer. It occurs at the entry to the rectum, and pathologists can easily distinguish it on biopsy. It is often, but not always, caused by infection with the human papilloma virus, or HPV. This is the virus that causes cervical cancer and has been associated with some cancers of the throat and the foreskin of the penis.

Men and women who participate in receptive anal intercourse, especially at an early age, are at increased risk for anal cancer. There is no prevention for those infected. There is some evidence that HPV vaccination before infection prevents cancers of the anus, throat and cervix (in women) and penis. Anyone in the risk group who has a concern in this area should seek medical attention.

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