Patterns of anal carcinoma by gender and marital status in Los Angeles County.

Marital status and other characteristics of 970 residents of Los Angeles County in whom cancer of the anus (including perianal skin) was diagnosed during the period 1972-1981 were compared with those of all county residents and all other persons in whom cancer was diagnosed during the same period. The incidence rate of anal cancer for single males was 6.1 times that for married males (P less than 0.001). This excess was limited to squamous and transitional cell carcinomas and was reasonably consistent by age, stage, subsite, social class and race. Single women were not at increased risk, but separated and divorced persons of both sexes were at increased risk compared to married persons. Anal cancers were more common in males under the age of 35, after which there was a substantial female predominance. This relative excess in older women occurred at all stages, subsites, and social classes of whites and also in blacks, but not in Hispanics, among whom women had lower overall incidence rates compared to both whites and blacks. The findings were consistent with the hypothesis that sexual activity involving the anus is related to anal cancer. We could not rule out the possibility that anal cancer is related to the acquired immune-deficiency syndrome (AIDS) since the incidence in young single men appears to have increased in 1980 and 1981.