Published online Sep 20, 2024. doi: 10.5493/wjem.v14.i3.98525
Revised: July 15, 2024
Accepted: August 6, 2024
Published online: September 20, 2024
Processing time: 61 Days and 23.8 Hours
Anal carcinoma is a relatively rare tumor that accounts for approximately 2% of gastrointestinal malignancies and less than 7% of anorectal cancers. Most anal tumors originate between the anorectal junction and the anal verge. Risk factors for the disease include human papillomavirus infection, human immunodeficiency virus, tobacco use, immunosuppression, female sex, and older age. The pathogenesis of anal carcinoma is believed to be linked to human papillomavirus-related inflammation, leading to dysplasia and progression to cancer. Squamous cell carcinoma is the most common type of anal tumor, with an annual incidence of approximately 1 to 2 per 100000 persons. Treatment regarding anal cancer has emerged over time. However, chemoradiation therapy remains the mainstay approach for early localized disease. Patients with metastatic disease are treated with systemic therapy, and salvage surgery is reserved for disease recurrence following chemoradiation. This article aims to provide background information on the epidemiology, risk factors, pathology, diagnosis, and current trends in the management of anal cancer. Future directions are briefly discussed.
Core Tip: Anal cancer is a rare malignancy, comprising 1%-6% of anorectal tumors. The incidence of anal carcinoma has been steadily increasing worldwide, and diagnosis is often challenging due to the similarities in clinical presentation to benign rectal diseases such as hemorrhoids. Roughly 85% of anal cancers are squamous cell carcinoma, and human papillomavirus infection and immunosuppression are major risk factors for the disease. Chemoradiation is the treatment of choice for early-stage cancer, while systemic therapy is used for metastatic disease. Novel cytotoxic agents in combination with immunotherapy have produced favorable outcomes in patients with advanced disease.