Diagnosis
Anal cancer
Neoplasms of the anorectal region that are classified into tumors of the perianal skin and tumors of the anal canal.
Also known as: Anal carcinoma
Etiology
Cause/Pathophysiology [qtm]
Anal infection with human papillomavirus (HPV) --> genital warts --> chronic infection --> major risk factor for cancer
Cancer types: squamous cell carcinoma (85% of cases), verrucous carcinoma, adenocarcinoma, melanoma, neuroendocrine tumors
Risk factors [duz][qtm]
Active HPV infection
Smoking
Anoreceptive sex
Immunosuppression
HIV infection
Solid organ transplantation
HPV‐related gynecological precancerous lesions or cancer
Epidemiology
Incidence per 100.000 [ss9][1td][bva]
Symptoms & findings
Symptoms
Dyschezia, Fecal incontinence, Hematochezia, Pruritus
Clinical findings
Elevated CEA, Elevated Sedimentation Rate
Anamneses
None listed.
Localized findings
Approach
Blood test: Complete blood count (anemia), liver function (metastasis), HIV [qtm]
Rectal exam
Anoscopy
Rectoscopy
Endoanal ultrasound
MRI
PET-CT
Biopsy
Hemofec
Treatment
Radiation therapy combined with radiosensitizing chemotherapeutic agents [duz][qtm]
Surgery plays a limited role
Differential diagnoses
Anal fissure, Anorectal abscess, Anorectal fistula, Bowens disease, Chancroid, Condyloma acuminatum, Hemorrhoids, HIV, Human papillomavirus, Immunodeficiency, Malignant melanoma, Paget's disease, Psoriasis
References
[1] Ramos Santillan V, Kaur A, Menon G, et al. Anal Carcinoma. [Updated 2025 Apr 12]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441891/
[2] https://emedicine.medscape.com/article/2500052
[3] https://seer.cancer.gov/statfacts/html/anus.html
[4] Johnson et al. Anal cancer incidence and survival: the surveillance, epidemiology, and end results experience, 1973-2000. Cancer. 2004 Jul 15;101(2):281-8.
[5] https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/anal-cancer/