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.
- Incidence: ∼ 8000 cases diagnosed per year in the U.S.
- More common in HIV-positive individuals and men who have sex with men
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
- Digital rectal exam
- Invasive procedures
- Staging: endosonography, abdominal ultrasound, abdominal CT, pelvic MRI, chest x-ray/CT
- Histology: primarily squamous cell carcinoma; rarely adenocarcinoma or other non-epidermoid cancers
Anal canal cancer
- Treatment of choice: radiochemotherapy
- Recurrent cancers are treated surgically.
- Anal margin cancer
We list the most important complications. The selection is not exhaustive.