The Role of Inflammation in Anal Cancer

Abstract

The aim of this article was to present a summary of the current resources available in the literature regarding the role of inflammation in anal cancer development. Anal cancer is relatively uncommon, accounting for about 2.7% of all reported gastrointestinal cancers in the United States. However, the importance of understanding the pathogenesis and risk factors for anal cancer has been recognized over the last several decades due to a noticed increase in incidence worldwide. Infections, autoimmune diseases, and inflammatory diseases of unknown etiology cause chronic inflammation that promotes tumorigenesis. The association between chronic inflammation and cancer development is widely accepted. It is based on different pathophysiological mechanisms that lead to cellular transformation and changes in immunological response, allowing tumor cells to avoid apoptosis and immune surveillance. However, there are still many molecular and cellular mechanisms that remain largely unexplored. Further studies on this topic could be of tremendous significance in elucidating anal cancer pathogenesis and developing immunotherapeutic approaches for its treatment.

La importancia de la anoscopia de alta resolución para la detección temprana de lesiones intraepiteliales escamosas anales de alto riesgo en pacientes con enfermedad inflamatoria intestinal y tratamiento inmunosupresor

“…Por otro lado, es fundamental tener en cuenta la asociación entre las fístulas perianales y el desarrollo de cáncer en pacientes con EII, un vínculo que ha sido documentado en la literatura médica. Los estudios metaanalíticos han revelado una incidencia combinada de cáncer relacionado con fístulas de 0.2 por cada 1,000 años-paciente, lo que subraya la necesidad de una atención minuciosa a los pacientes con EII y patología perianal crónica 4 .…”

“…En la mayoría de los casos, las ASIL se desarrollan en pacientes con enfermedad de Crohn (EC) que se diagnostica en el contexto de una enfermedad perianal crónica de larga evolución, que suele extenderse por más de 10 años. Esta enfermedad perianal crónica se caracteriza por la presencia de fístulas anales, ulceraciones y áreas de estenosis en el canal anal, que aumentan el riesgo de desarrollar ASIL y, potencialmente, SCC [4][5][6] .…”

Perianal disease in inflammatory bowel disease: Broadening treatment and surveillance strategies for anal cancer

“…These risk factors seem to validate the role of chronic inflammation in tumorigenesis, providing yet another reason why we should be increasingly ambitious with our therapeutic targets in perianal CD. In addition to systemic and local inflammatory processes, the pathophysiological mechanisms that lead to anal cancer in IBD are also related to human papilloma virus (HPV) infection, decreased local gut immunity and drug-induced immunosuppression[ 13 , 87 ].…”