Tobacco smoking and risk of recurrence for squamous cell cancer of the anus

Abstract

Objective Squamous cell cancer of the anus is associated with multiple risk factors, including infection with human papillomavirus, immunosuppression, chronic inflammation, and tobacco smoking, although there is little data on these factors for the prediction of recurrent disease. Here, we evaluated the risk of recurrence and mortality of anal carcinoma in association with tobacco smoking. Methods We conducted a retrospective review of cases of anal carcinoma from two local hospitals. We obtained information on treatment response and cancer recurrence, as well as tobacco usage from medical records. Results We identified 64 patients with squamous cell cancer of the anus, and 34 of these (53%) had a tobacco smoking history. Current smokers had higher carcinoma recurrence rates (11/34, 32%) than non-smokers (6/30, 20%). Overall mortality was 33%(21/64), and cancer-related mortality was 23%(15/64). Smokers were more likely to die from recurrence than non-smokers, with 45% of smokers dead compared to only 20% of non-smokers by 5 years after treatment. Conclusion Tobacco smoking appears to be associated with anal carcinoma disease recurrence, and is related to increased mortality. This data suggests that patients should be cautioned about tobacco smoking once a diagnosis of anal carcinoma is made in attempt to improve their long-term outcome.

Anal carcinoma in human immunodeficiency virus-positive men: results of a prospective study from Germany

“…Tobacco smoking is a well‐established risk factor for HPV‐associated anogenital cancer. It was recently shown that smokers with anal cancer are more likely to die from recurrence than nonsmokers, with 45% of smokers being dead compared with only 20% of nonsmokers by 5 years after treatment 33 . In line with this, only one patient with canal ASCC had long‐term response to CRT, and this patient had never smoked.…”

Racial Disparity in Gastrointestinal Cancer Risk

“…As such, little is known about the etiology of the adenocarcinoma type. Smoking is reported as a risk factor that correlates with anal cancer, especially in those with HPV infections [122,123]. …”

Giant Perianal Basal Cell Carcinoma: An Uncommon Localization: Case Report

“…However, the role of smoking in the development of perianal BCC has not yet been determined. 9 Perianal BCC cases have also been reported in patients receiving pelvic radiotherapy due to genitourinary system malignancies. 1,2,5 In a study performed by Eliezri et al, HPV DNA type 16 infection has been shown in biopsy specimens of BCCs developed in sun exposed areas, such as head and neck.…”

“…10 In another study that investigated the role of HPV in the etiology of BCC, no relationship was found. 9 The presented patient had no history of pelvic radiotherapy or chronic trauma and showed no HPV DNA with PCR analysis in the biopsy specimens.…”