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Conclusion We found that adolescent girls engage in a range of sexual behaviors, with cultural differences in their choices of which behaviors to engage in and when. A risk factor is something that increases the risk of developing cancer. The mechanism behind smoking and anal-cancer development is unknown, but researchers speculate that smoking interferes with a process called apoptosis, or programmed cell death, which helps rid the body of abnormal cells that could turn cancerous. External link. Future studies should explore these differences in greater depth in order to develop culturally specific STI prevention efforts. Included in the survey were Black males, Black females, 40 Black women and anal sex with white man males, and 64 White females attending the same college in the southern US.