Changing nature of anal cancer.

Abstract

Radical operations can often be avoided Anal cancer is rare, accounting for about 2% of all anorectal cancers or 300 cases a year in Britain.' Epidemiological studies from the United States have highlighted the striking association of syphilis and anal warts with anal cancer in unmarried men.23 Gonorrhoea, syphilis, and anal warts are more common in homosexual than heterosexual men,4 and carcinoma in situ may develop in the anal warts of young anoreceptive homosexual men, a change that has been seen in patients with AIDS.5 In a recent comparison of risk factors for squamous cell carcinoma of the anus and cancer of the colon receptive anal intercourse and anal warts were high risk factors for anal cancer in men but not in women.6 Squamous cell carcinomas of the cervix, vulva, and penis are associated with the sexual transmission of human papillomaviruses. Human papillomavirus 16 is the predominant type associated with invasive cervical cancer, but it is less often associated with cervical dysplasia and genital warts.7 The types of human papillomavirus most commonly

Patterns of local disease failure and outcome after salvage surgery in patients with anal cancer

“…Anal carcinoma is an uncommon malignancy with an annual incidence of 0·5–1·0 per 100 000 population in most Western countries1. Over the past two decades, primary treatment by surgical resection has been largely superseded by sphincter‐preserving therapy using radiotherapy with or without chemoinduction2. Two randomised trials3, 4 showed significant gains in local control and a reduction in the need for colostomy when synchronous chemoradiotherapy with 5‐fluorouracil and mitomycin C was used, compared with radiotherapy alone.…”

Salvage Surgery for Anal Canal Ca. Long Term Outcomes From a Tertiary Referral Centre

“…Anal canal cancers account for only 2% of all large bowel cancers. [1,2] With the introduction of combined CRT as the primary treatment modality, 5-year survival rates improved. [6][7][8] On the contrary, the morbidity also decreased as more and more patients had sphincter preservation.…”

“…Standard treatment of these cancers was by surgical resection with poor survival outcomes of 27-71% with a high rate of local recurrence. [1][2][3][4] With the introduction of neoadjuvant chemoradiation, survival outcomes have increased to 65-90% with local recurrence rates of 10-30%. Accordingly, chemoradiotherapy (CRT) has become the preferred choice of treatment and is now widely accepted, [5][6][7][8] with radical surgery being reserved for patients with residual or recurrent disease.…”