Anal cancer includes anorectal cancer, anal canal cancer and anal margin cancer. Clinically, rectal cancer within 4cm of anus is often categorized as anal cancer. Anal cancer is relatively rare and not a common disease in China, but in recent years, its incidence rate has been gradually increasing. Overseas countries also have this trend, and there was an article in the New England Journal of Medicine pointing out that the incidence rate of anal cancer in men and women is increasing by about 2% per year. Exploring the reasons for the rising incidence of anal cancer, many believe that the advent of the Internet has made it easier for people to socialize. Society tends to be more tolerant, allowing gay communities and some gay associations to begin to be able to appear openly, and the general population is becoming more tolerant of homosexuality. Gay men are more likely than ever to find their sexual partners for anal sex. Of course there is a percentage of heterosexuals who enjoy anal sex as well. Some doctors believe that this is one of the reasons why the incidence of anal cancer has continued to rise in recent years. I don’t discriminate against gay men or people who enjoy anal sex, but as a doctor I know some of the risks of anal sex, so I came to write this article. If we don’t make people aware of these risks, we can expect the incidence of anal cancer to increase in the near future. In the United States, anal cancer occurs at about the same rate in men and women. Studies have pointed out that homosexuals and those who test positive for HPV are at a higher risk of developing anal intraepithelial neoplasia and anal cancer. The causative mechanism of anal cancer may be multifaceted and has nothing to do with dietary habits; it is related to HPV, Chlamydia trachomatis, cigarette smoking, chronic anal irritation, and chromosomal abnormalities. Overseas studies show that about 90% of anal cancer is associated with HPV infection. Anal cancer is mainly caused by infection with human papillomavirus HPV, which is mainly transmitted by sexual contact. Of the more than 150 types of HPV, 40 are known to infect the human reproductive organs, causing cervical, penile, vaginal and anal cancers. According to the U.S. Centers for Disease Control and Prevention, 80% of anal cancers are linked to HPV16 or HPV18, and the main route of infection is anal sex. The symptoms of anal cancer, which are very similar to hemorrhoids, often include discomfort and itching in the anal area, a sensation of having a bowel movement that is not clear, and a lump that can be found on the anal rim. There is pain when anal cancer invades the anal canal or sphincter. In later stages of the cancer, if an ulcer forms, there will be pain when passing stool. In the advanced stage, weight loss will occur as in other cancers. Therefore, if you find out that you have hemorrhoids for the first time, you must go to the hospital and ask the doctor to confirm whether it is anal cancer or hemorrhoids, so as to avoid mistaking anal cancer for hemorrhoids and delaying the treatment. Diseases should be prevented, now let’s talk about how to prevent anal cancer. First of all, it is important to have a set of safety precautions when anal popping and that is to use condoms throughout. Secondly, it is also recommended that these people get the HPV vaccine, which the Centers for Disease Control and Prevention confirms that the HPV vaccine (including bivalent, quadrivalent, or tetravalent) can prevent anal cancer. In the United States and in Taiwan and Hong Kong, men are also vaccinated against HPV to prevent cancers such as penile and anal cancers. It is recommended that anyone who enjoys anal fapping should consider getting the HPV vaccine. Anal sex has never been the exclusive fetish of gay men, and there are heterosexuals who like to play this way. I also hope that HPV vaccine will be introduced in our country as soon as possible and HPV vaccination will be carried out.