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Researchers from the Medical University of South Carolina (MUSC) Hollings Cancer Center have identified cervical cancer as a potential risk factor of future anal cancer, publishing their findings in JAMA Network Open.¹

While anal cancer screening is recommended in organ transplant recipients, people living with HIV, and women with a history of vulvar cancer, screening guidelines have not been established for women with cervical cancer. This data highlights a nearly 2-fold increased risk of anal cancer in this population, potentially influencing future guidelines.¹

“We’ve known for a long time that both cervical and anal cancers are caused by HPV, the human papillomavirus,” said Haluk Damgacioglu, PhD, study lead and assistant professor at MUSC. “But what hasn’t been well-understood is how that shared risk might connect the 2 diseases over a woman’s lifetime.”¹

Cervical and anal cancer incidence rates

The cohort study was conducted to estimate anal cancer incidence since cervical cancer diagnosis.² Data was obtained from the National Cancer Institute’s Surveillance, Epidemiology, and End Results registries. International Classification of Disease for Oncology codes were referenced to determine cancer cases.

Women receiving an anal cancer diagnosis before or within 2 months of cervical cancer diagnosis were excluded from the analysis. A multiple primary standardized incidence ratios session was utilized to calculate overall, age-specific, and time since diagnosis-specific incidence rates (IRs) per 100,000 person-years.²

There were 822,630 person-years of follow-up across 85,524 cervical cancer patients diagnosed from 1975 to 2021 evaluated. In the study population, 64 anal cancer diagnosis cases were identified, indicating an overall incidence of 7.8 per 100,000 person-years.²

Age- and time-based differences

Differences in anal cancer incidence rates were highlighted across age groups and time since cervical cancer diagnosis. An IR of 2.4 was reported for women aged under 45 years with a history of cervical cancer but rose to 4.6 for those aged 45 to 54 years and 10.0 for those aged 54 to 64 years.²

Women aged 65 to 74 years presented with the greatest IR of 17.6, while those aged at least 75 years had an IR of 10.0. When assessing the incidence based on time since cervical cancer diagnosis, an IR of 5.8 was reported in the first 5 years. Additional IRs included 5.1 for 5 to 10 years, 12.7 for 10 to 15 years and 16.1 for 20 or more years.²

Of anal cancer diagnoses in women aged 65 to 74 years, 59% occurred over 15 years following cervical cancer diagnosis. Overall, a standardized incidence ratio of 1.9 was reported for anal cancer, with elevated risk persisting over time following cervical cancer diagnosis. This indicated a significant increase in risk among cervical cancer patients.²

Implications

Cervical cancer has a survival rate of over 90% when found early thanks to routine screening and the HPV vaccine.¹ However, this is one of the first studies to evaluate potential next steps in these patients who may experience elevated risks of related cancers.

“We don’t have the resources to screen everyone,” said Deshmukh. “But we can use these data to be strategic. Screening based on risk ensures we help the people who need it most.”¹

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

In a newly published qualitative study in Headache, researchers identified patients who frequently reported prodromal symptoms, often noting that a migraine headache followed their prodrome in a 1- to 6-hour window. These findings suggest that characterizing the prodrome experience could improve strategies for measuring migraine burden and offer opportunities to initiate treatment during the prodromal phase to prevent moderate or severe headache.¹

Using 20 patient interviews from March 2022 to May 2022, participants reported 36 unique prodromal symptoms, and each patient had a mean of 13 symptoms (SD, 6.6) and a median of 11 symptoms (IQR, 7.8-17.0) during the prodrome phase. Most of the commonly reported prodromal symptoms included nausea (85%), fatigue/tiredness (80%), sensitivity to light (65%), neck pain/stiffness (60%), and dizziness/vertigo/light-headedness (50%).

‘This study is one of the first to assess the humanistic burden of migraine prodrome from the patient perspective. Findings related to symptom timing contribute to the distinction between migraine phases as well as the progression of prodromal symptoms. Specifically, people with migraine are often uncertain about when to take medication; currently, we instruct patients to treat early, while pain is mild, but not too often. This study sets the stage for assessing the benefits of treating in the prodrome phase, when initial symptoms that signal impending headache develop,” lead author Richard B. Lipton, MD, director of the Montefiore Headache Center at Albert Einstein College of Medicine, and colleagues wrote.¹

For the current study, investigators included patients who had a clinician-confirmed diagnosis of migraine and at least 1 prodromal symptom; participants were consented, screened, and then completed 60-minute interviews. During the interviews, researchers asked participants open-ended questions to capture spontaneous reports, along with specific probes based on a clinician-established list of prodromal symptoms. Utilizing a theory approach², authors analyzed the qualitative data gathered from each of the interviews to uncover key themes and retrieve insights.

READ MORE: Analyzing Eptinezumab’s Ability to Extend Interictal Periods and Reduce Migraine Burden

Among symptoms reported by at least 4 participants (20%), patients rated neck pain/stiffness as the most bothersome (8.9/10), whereas sensitivity to light was rated as the most severe (8.5/10). Authors noted that nearly 40% of all reported symptoms by patients appeared in 2 hours of migraine onset. Of the commonly reported symptoms, nausea (0.8 h), sensitivity to light (1.0 h), and dizziness/vertigo/light-headedness (2.0 h) occurred closest to headache onset, whereas fatigue/tiredness (4.0 h) and neck pain/stiffness (4.8 h) appeared earlier.

Migraine attacks typically progress through 4 stages, including the prodrome or premonitory phase, aura, headache, and postdrome. However, authors noted that qualitative data on the variety of symptoms experienced during the prodrome and their timing relative to headache onset have been limited. Therefore, investigators recommended that understanding these early symptoms could help predict when a migraine headache will occur and offer a clinically useful window to begin treatment before pain develops.

“Prodrome symptom identification could encourage early treatment intervention, possibly resulting in improved efficacy and better patient outcomes. The findings herein can be used to inform future studies exploring this potential benefit,” Lipton et al noted.¹ “Specifically, more research is needed to explore the incidence of migraine prodrome across a larger patient population, including whether early intervention with acute migraine medication leads to the reduction of migraine headache pain, or prevents its onset altogether. This future research will aid the effort to mitigate the incidence and humanistic burden of migraine attacks.”

REFERENCES
1. Lipton RB, Stokes J, Evans CJ, et al. Characterizing the patient experience during the prodrome phase of migraine: A qualitative study of symptoms and their timing. Headache. Published online September 1, 2025. doi:10.1111/head.15024
2. Glaser BG, Strauss AL. The constant comparative method of qualitative analysis. In: Glaser BG, Strauss AL, eds. The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine de Gruyter; 1967:101-115.