Management of anal cancer

Anal cancer is a rare malignancy, accounting for 2 % of colorectal cancer diagnoses. Over the last few decades, the number of new cases diagnosed has been increasing, driven by multifactorial etiology and associated with HPV infection, smoking, high-risk sexual activity, and immunocompromise. The primary histologic type of anal cancer is squamous cell carcinoma. While historically these tumors were treated with abdominoperineal resection, today the primary treatment is combined modality chemoradiotherapy. Success rates can be as high as 80 %, with APR primarily used as salvage therapy for persistent or recurrent disease. Despite the success of combined modality therapy, investigations are ongoing to discover methods that will improve survival and avoid the need for colostomy.