• Clinical science

Anal cancer

Summary

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.

Epidemiology

  • Incidence: ∼ 8000 cases diagnosed per year in the U.S.
  • More common in HIV-positive individuals and men who have sex with men

References:[1][2]

Epidemiological data refers to the US, unless otherwise specified.

Etiology

References:[2]

Clinical features

  • 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

References:[2]

Diagnostics

References:[2]

Pathology

References:[2][3]

Treatment

References:[2]

Complications

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

References:[4]

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