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squamous cell carcinoma (SCC) of the anus
Etiology:
1) human papillomavirus
-> same forms linked to SCC of the cervix & penis
2) increased incidence in homosexual men with or without HIV1 infection [6,7]
Pathology:
- slow progression or anal intraepithelial neoplasia to squamous cell carcinoma of the anus [2]
Management:
- treatment:
- radiation therapy plus chemotherapy
- chemotherapy consists of 5-fluorouracil + mitomycin
- 50.4 Gy radiotherapy in 28 daily fractions [4]
- surgical resection is generally avoided because it removes anal sphincter muscles necesitating a permanent colostomy [1]
- contrast with rectal cancer in which surgical resection is the method of treatment [1]
- screening not recommended [2]
Related
anus
papillomavirus
rectal carcinoma
General
anal cancer
squamous cell carcinoma of the skin (SCCS)
References
- Medical Knowledge Self Assessment Program (MKSAP) 11, 16, 18.
American College of Physicians, Philadelphia 1998, 2012, 2018.
- Machalek DA et al
Anal human papillomavirus infection and associated neoplastic
lesions in men who have sex with men: a systematic review
and meta-analysis
The Lancet Oncology, Early Online Publication, 23 March 2012
PMID: 22445259
http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70080-3/fulltext
- Wentzensen N
Screening for anal cancer: endpoints needed
The Lancet Oncology, Early Online Publication, 23 March 2012
PMID: 22445258
http://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(12)70101-8/fulltext
- Meyer J, Willett C, Czito B.
Current and emerging treatment strategies for anal cancer.
Curr Oncol Rep. 2010 May;12(3):168-74
PMID: 20425076
- James RD, Glynne-Jones R, Meadows HM et al
Mitomycin or cisplatin chemoradiation with or without maintenance
chemotherapy for treatment of squamous-cell carcinoma of the anus
(ACT II): a randomised, phase 3, open-label, 2 2 factorial trial.
Lancet Oncol. 2013 May;14(6):516-24.
PMID: 23578724
- Steele SR, Varma MG, Melton GB et al
Practice parameters for anal squamous neoplasms.
Dis Colon Rectum. 2012 Jul;55(7):735-49
PMID: 22706125
(corresponding NGC guideline withdrawn Dec 2017)
- Park IU, Palefsky JM.
Evaluation and Management of Anal Intraepithelial Neoplasia
in HIV-Negative and HIV-Positive Men Who Have Sex with Men.
Curr Infect Dis Rep. 2010 Mar;12(2):126-33. Epub 2010 Feb 24.
PMID: 20461117 Free PMC
- Geriatric Review Syllabus, 9th edition (GRS9)
Medinal-Walpole A, Pacala JT, Porter JF (eds)
American Geriatrics Society, 2016
- National Cancer Institute
Anal Cancer - Health Professional version
https://www.cancer.gov/types/anal/hp