Anal cancer

Anal carcinoma is a rare tumor that has a closer association with genitourinary malignancy than with gastrointestinal malignancy and has been increasing in incidence over the past few decades. Disease often will arise from a high grade anal intraepithelial neoplasm. There are multiple risk factors that can be cumulative including human papillomavirus (HPV) infection, cigarette smoking, anoreceptive intercourse, and immunosuppression. While there is no direct relationship between HIV and anal carcinoma, there is an association and a higher incidence in HIV-positive patients. While treatment of anal carcinoma was initially surgical with abdominoperineal resection, the recommendation now is for mitomycin and fluorouracil based concurrent chemoradiation therapy, with surgery reserved for those patients with residual disease.