Anal cancer

Last updated: August 5, 2021

Summarytoggle arrow icon

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.

Epidemiologytoggle arrow icon

Epidemiological data refers to the US, unless otherwise specified.

Etiologytoggle arrow icon

Clinical featurestoggle arrow icon

Diagnosticstoggle arrow icon

Pathologytoggle arrow icon

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Complicationstoggle arrow icon

  • Metastasis
    • Local invasion of adjacent organs
    • Lymphatic spread (30% of patients): perirectal, paravertebral, inguinal, femoral
    • Hematogenous spread (< 10% of patients): liver, bone, lung [4]

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

Prognosistoggle arrow icon

  • Anal cancer of the dentate line: The 5-year survival rate after radiochemotherapy is > 80%.
  • Anal cancer of the anal verge: The prognosis is favorable if complete local excision is possible. The 5-year survival rate after rectal amputation is approx. 50%.


Referencestoggle arrow icon

  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. Anal cancer treatment. Updated: June 3, 2021. Accessed: July 12, 2021.
  4. Metastatic patterns of anal cancer. Updated: August 22, 2014. Accessed: December 6, 2016.
  5. Touboul E, Schlienger M, Buffat L, et al. Epidermoid carcinoma of the anal canal. Results of curative-intent radiation therapy in a series of 270 patients.. Cancer. 1994; 73 (6): p.1569-79.doi: 10.1002/1097-0142(19940315)73:6<1569::aid-cncr2820730607>;2-f . | Open in Read by QxMD

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 Evidence-based content, created and peer-reviewed by physicians. Read the disclaimer