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Anal cancer

Last updated: March 11, 2021

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Anal cancer is a rare tumor. Risk factors include infection with human papillomavirus (HPV), immunodeficiency, and receptive anal intercourse. The most common clinical features are rectal bleeding (up to 45% of cases), pruritus ani, and tenderness or pain in the anal area. Anal cancer presents mainly as squamous cell carcinoma and in rare cases as adenocarcinoma or other non-epidermoid cancers. Depending on the exact localization and stage, it requires excision and/or radiochemotherapy. If the condition is treated in its early stages, the prognosis is favorable.

Epidemiological data refers to the US, unless otherwise specified.

  • Rectal bleeding (most important initial symptom)
  • A lump or tumor around the anus
  • Pruritus ani
  • Tenderness, pain in the anal area
  • Fecal incontinence
  • History of anorectal condyloma

  • Metastasis
    • Local invasion of adjacent organs
    • Lymphatic spread (30% of patients): perirectal, paravertebral, inguinal, femoral
    • Hematogenous spread (< 10% of patients): liver, bone, lung [3]

We list the most important complications. The selection is not exhaustive.

  1. Siegel RL, Miller KD, Ahmedin J. Cancer statistics, 2016. CA: A Cancer Journal for Clinicians. 2016; 66 : p.7-30. doi: 10.3322/caac.21332 . | Open in Read by QxMD
  2. Glynne-Jones R, Nilsson PJ, Aschele C, et al. Anal cancer: ESMO-ESSO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Annals of Oncology. 2014; 25 : p.iii10-iii20. doi: 10.1093/annonc/mdu159 . | Open in Read by QxMD
  3. Metastatic patterns of anal cancer. http://oncolex.org/Anal-cancer/Background/MetastaticPattern.aspx. Updated: August 22, 2014. Accessed: December 6, 2016.