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July 19, 1985

Re: Causes of Anal Carcinoma

Author Affiliations

Redding, Calif

JAMA. 1985;254(3):358. doi:10.1001/jama.1985.03360030048010

To the Editor.—  The recent report in The Journal by Daling et al1 plus the six case reports they cite2,3 and two others reported by Frederick et al4 apparently identify male homosexuality as the first recognized risk factor for epidermoid carcinomas of the anus. Both the physical trauma of anal sex and the potential presence of sexually transmitted infections including herpes have been suggested as factors possibly contributing to this association. The potential for a similar association among women, who develop these tumors more frequently than do men, is suggested by the report of Bolling5 in which the frequency with which an urban population of women participated habitually in anal sex was much higher than the reported frequency of male homosexuality.Since little else is known about the etiology of these tumors, another observation suggesting an additional risk factor should be of interest. During a review