Anal Cancer: Emerging Standards in a Rare Disease

Abstract

The social stigma surrounding an anal cancer diagnosis has traditionally prevented open discussions about this disease. However, as recent treatment options and an increasing rate of diagnoses are made worldwide, awareness is growing. In the United States alone, 9,090 individuals were expected to be diagnosed with anal cancer in 2021. The US annual incidence of squamous cell carcinoma of the anus continues to increase by 2.7% yearly, whereas the mortality rate increases by 3.1%. The main risk factor for anal cancer is a human papillomavirus infection; those with chronic immunosuppression are also at risk. Patients with HIV are 19 times more likely to develop anal cancer compared with the general population. In this review, we have provided an overview of the carcinoma of the anal canal, the role of screening, advancements in radiation therapy, and current trials investigating acute and chronic treatment–related toxicities. This article is a comprehensive approach to presenting the existing data in an effort to encourage continuous international interest in anal cancer.

State Variation in Squamous Cell Carcinoma of the Anus Incidence and Mortality, and Association With HIV/AIDS and Smoking in the United States

“…Ongoing clinical trials evaluating novel treatment options (eg, cytotoxic therapy and immunotherapy) represent an important opportunity for treatment advances. 37 Our study also has important implications for primary prevention through HPV vaccination. Unfortunately, regions/states (mostly in the Midwest and Southeast regions) that are currently seeing a marked rise in SCCA incidence have some of the lowest HPV vaccination coverage in the nation and have the highest level of parental HPV vaccine hesitancy, with more than half of parents of unvaccinated adolescents lacking the intention to initiate the HPV vaccination series in each state.…”

“…Furthermore, continuous improvement in the treatment for SCCA for both early-stage and late-stage disease and the development of appropriate treatment infrastructure are also needed. 37 Particularly, unmet needs in terms of the lack of treatment options remain for patients who present with surgically unresectable or metastatic disease. Ongoing clinical trials evaluating novel treatment options (eg, cytotoxic therapy and immunotherapy) represent an important opportunity for treatment advances.…”

Rational treatment options for T1/2N0M0 squamous cell carcinoma of the anal canal: A retrospective study combined with external validation

“…Although the incidence of anal canal cancer is lower than that of colorectal cancer, it is increasing yearly and it is more common in women, underscoring the need to pay attention to this disease [2]. Squamous cell carcinoma of the anus (SCCA) is the most common anal canal cancer, and its incidence is related to high risk factors such as HIV, HPV, smoking, history of sexually transmitted diseases, cervical cancer, perineal tumors, and immunosuppression [3][4][5]. The treatment of SCCA has changed from combined abdominal and perineal resection in the 1970s to a comprehensive treatment based on radiotherapy (RT) and chemotherapy (CT).…”

Biomarkers in Anal Cancer: Current Status in Diagnosis, Disease Progression and Therapeutic Strategies

“…The most common histology is squamous cell carcinoma (SCCA), responsible for 80% of the cases. Less frequent subtypes include adenocarcinoma, neuroendocrine tumors, malignant melanoma, lymphomas, and mesenchymal tumors [ 1 , 2 ]. In the United States (US), 9090 new cases of SCCA were expected in 2021 [ 3 , 4 ] and the annual incidence of SCCA continues to increase by 2.7% yearly, with a mortality rate rising by 3.1% [ 5 , 6 , 7 ].…”