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The Community Oncologist: Duke Oncology Fellows Series

Anal Cancer: An Overview

^aDepartment of Medicine, Divisions of Medical Oncology and Hematology, and ^bDepartment of Medicine, Division of Medical Oncology, Duke University Medical Center, Durham, North Carolina, USA

Key Words. Anal cancer • Chemotherapy • Radiation therapy • Surgery

Correspondence: Hope E. Uronis, M.D., Duke University Medical Center, Box 3841, Durham, North Carolina 27710, USA. Telephone: 919-684-2287; Fax: 919-684-3309; e-mail: hope.uronis{at}duke.edu

Anal cancer is a rare tumor with an incidence that has been rising over the last 25 years. The disease was once thought to develop as a result of chronic irritation, but it is now known that this is not the case. Multiple risk factors, including human papillomavirus (HPV) infection, anoreceptive intercourse, cigarette smoking, and immunosuppression, have been identified. HIV infection is also associated with anal cancer; there is a higher incidence in HIV-positive patients but the direct relationship between HIV and anal cancer has been difficult to separate from the prevalence of HPV in this population. HIV infection is also associated with anal cancer; there are increasing numbers of HIV-positive patients being diagnosed with the disease. Treatment of anal cancer prior to the 1970s involved abdominoperineal resection, but the standard of care is now concurrent chemoradiation therapy, with surgery reserved for those patients with residual disease. We present a case of anal cancer followed by a general discussion of both risk factors and treatment.

Disclosure of potential conflicts of interest is found at the end of this article.

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