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Anal cancer

Last updated: August 5, 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 [4]

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

  • 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%.

References:[5]

  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. https://www.cancer.gov/types/anal/hp/anal-treatment-pdq#_36. Updated: June 3, 2021. Accessed: July 12, 2021.
  4. Metastatic patterns of anal cancer. http://oncolex.org/Anal-cancer/Background/MetastaticPattern.aspx. 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>3.0.co;2-f . | Open in Read by QxMD