Anal cancer

Anal cancer is cancer of the anus, which is caused by HPV (human papillomavirus) in 90% of cases. The cancer is often preceded by a precancerous stage.

Over 89% of cases are due to a persistent HPV infection. Other risk factors are frequently changing sexual partners, passive anal intercourse, HIV infection, immunodeficiency (e.g., after organ transplants) and smoking.

Anal cancer is rare, with approx. 1,600 new anal cancer cases in the UK per year. Women are affected twice as often as men. The 5-year survival rate is around 65% for women and 61% for men, depending on the stage of the disease.

Symptoms can include blood in the faeces, pain during bowel movements, itching, constipation, non-healing wounds, weight loss and night sweats. They are often mistaken for haemorrhoids.

A rectoscopy and tissue sample are necessary to make the diagnosis. A rectal ultrasound examination helps to determine the spread of the tumour. Early detection examinations are particularly recommended for HIV-positive people and other risk groups (e.g., after an organ transplant or women with another HPV-related cancer).

Usually, anal cancer is treated with a combination of radiotherapy and chemotherapy, sometimes also with surgery. The exact treatment strategy depends on the stage of the cancer.

Anal cancer can lead to long-term problems such as faecal incontinence or impaired quality of life due to pain or sexual dysfunction.

Good prevention includes HPV vaccination, regular screening and avoiding risk factors such as unprotected anal sex and smoking. HIV-positive individuals and at-risk groups should be regularly screened for anal cancer.