Anal Cancer : A Review

Polish Journal of Surgery, 2011

Journal of gastrointestinal oncology, 2010

Anal cancer used to be a rare cancer traditionally associated with elderly women. There are approximately 5260 cases per year in the U.S. (1). The onslaught of the Human Immunodeficiency Virus (HIV) virus has led to a change in anal cancer demographics. Anal cancer is on the rise in the U.S and the number of anal cases documented has quadrupled in the past 20 yrs correlating with the rise of the HIV epidemic. The incidence of anal cancer is 40 to 80 fold higher in the HIV positive (HIV+) population when compared to the general population (2). With the advent of highly active antiretroviral therapy (HAART), HIV+ patients are living longer as less are progressing to AIDS. As a consequence non AIDS defining cancers such as anal cancer are on the rise. Factors implicated in the etiology of anal cancer in HIV+ patients include (Human papillomavirus) HPV virus status, sexual habits, and a history of smoking. HPV 16 and receptive anal intercourse (RAI) increase the risk of anal cancer by 3...

Expert Review of Anticancer Therapy, 2009

Surgical Oncology Clinics of North America, 2004

British Journal of Cancer Research, 2020

Anal carcinoma is considered a rare tumour, accounting for 1.5% of the digestive tract tumours [1]. Historically, incidence is higher in women, but it seems to be increasing in both sexes, especially in males [2]. The most common histology is squamous cell carcinoma, which will be the focus of this review. Adenocarcinoma in this location should be managed according to the principles of rectal cancer and melanoma should be treated as such. The last few decades have witnessed an important evolution in the understanding of the pathogenesis and adequate treatment of this entity. Several risk factors have been described for anal carcinoma, including HPV and HIV infection, history of sexually transmitted diseases, history of anal intercourse, previous HPV-related gynecological cancers (vulvar, cervical and vaginal cancer), immunosuppressive disorders and tobacco smoking [1-6]. The usual clinical presentation is rectal bleeding, but mass sensation and/ or pain can also be described [7].Sta...

Clinics in Colon and Rectal Surgery, 2009

Our understandings of anal canal cancer pathogenesis and treatment have undergone significant changes due to continuing research into its pathogenesis and the results of major clinical trials conducted over the past 20 years. Anal canal cancer can be cured by combined modality chemoradiation therapy, a treatment that preserves continence and reserves abdominoperineal resection of the rectum and anal canal in patients with recurrent or residual disease after primary chemoradiotherapy. The research into more effective, less toxic therapies is continuing. Future challenges include an increasing incidence of human papillomavirus infection, the AIDS epidemic, diagnosis of early disease, and optimization of chemotherapy and radiation regimens. This article aims to provide a summary of recently completed and ongoing clinical trials in the management of anal canal cancer.

AIDS, 2008

on behalf of the FHDH-ANRS CO 4 Objective: To describe the cases of anal cancer that appeared in the French Hospital Database on HIV between 1992 and 2004 and to study risk factors of anal cancer. Methods: We examined the incidence rates of anal cancer between 1992 and 2004 and the risk associated among 86 322 HIV-infected patients included in the French Hospital Database on HIV.

Rev. Inst. Med. Trop. Sao Paulo, 2012

Squamous anal cell carcinoma is a rare malignancy that represents the 1.5% to 2% of all the lower digestive tract cancers. However, an increased incidence of invasive anal carcinoma is observed in HIV-seropositive population since the widespread of highly active antiretroviral therapy. Human papillomavirus is strongly associated with the pathogenesis of anal cancer. Anal intercourse and a high number of sexual partners appear to be risk factors to develop anal cancer in both sexes. Anal pain, bleeding and a palpable lesion in the anal canal are the most common clinical features. Endo-anal ultrasound is the best diagnosis method to evaluate the tumor size, the tumor extension and the infiltration of the sphincter muscle complex. Chemoradiotherapy plus antiretroviral therapy are the recommended treatments for all stages of localized squamous cell carcinoma of the anal canal in HIV-seropositive patients because of its high rate of cure. Here we present an HIV patient who developed a carcinoma of the anal canal after a long time of HIV infection under highly active antiretroviral therapy with a good virological and immunological response.

Current problems in surgery, 1989

Preservation of anorectal function makes chemoradiotherapy attractive as the primary treatment in patients with squamous cell carcinoma of the anal region. Despite variations in techniques of chemoradiotherapy administration, the accumulated experience of a number of institutions indicates substantial improvement over previous approaches, which included surgery or radiation therapy individually. Although no longer providing the definitive therapeutic role in this disease, the surgeon is frequently asked to evaluate lesions suspected of being anal malignancies. In addition, it is the surgeon who most often performs the diagnostic biopsy, consults on local complications of chemoradiotherapy, and manages complications of local recurrence. In this context, optimal care includes early organization of the medical oncologist, radiation therapist, and surgeon to participate in the initial diagnostic evaluations, examinations with the patient under anesthesia, and follow-up during therapy. A...

Journal of the National Comprehensive Cancer Network : JNCCN, 2018

The NCCN Guidelines for Anal Carcinoma provide recommendations for the management of patients with squamous cell carcinoma of the anal canal or perianal region. Primary treatment of anal cancer usually includes chemoradiation, although certain lesions can be treated with margin-negative local excision alone. Disease surveillance is recommended for all patients with anal carcinoma because additional curative-intent treatment is possible. A multidisciplinary approach including physicians from gastroenterology, medical oncology, surgical oncology, radiation oncology, and radiology is essential for optimal patient care.