Anal Cancer

The anus is the external opening of the rectum (the final part of the bowel), at the opposite end of the digestive tract to the mouth. Faeces (also known as “stool” or “poo”) exit the body via the anus. The anus is also an important part of many peoples’ sexuality, with abundant nerve endings, and is frequently used for pleasure, during anal sex.  

The anus is made up of circular bands of muscle, knowns as sphincters, and the pelvic floor muscles; blood vessels, and nerve endings; and perianal skin, which transitions to the lining of the gut. Anal cancer usually happens when normal cells lining the anus change into abnormal cells and grow out of control. Some other cancers can affect the anus, such as melanoma, and lymphoma. 

Importance for PLHIV50+

Although uncommon, anal cancer affects more men who have sex with men, who are living with HIV, than the general population. The most common type of anal cancer is called squamous cell carcinoma (SCC), and is usually related to human papilloma virus infection (HPV), which can cause genital warts, cervical, and other cancers. Risk factors for anal cancer, include a higher number of sexual partners, cigarette smoking, genital warts, and more advanced HIV infection.  

Symptoms of anal cancer include bleeding from or pain in or around the anus, a growth or mass in the anus, discharge or ulceration from the anus, or unexplained itching around the anus. Most of the time, anal cancers cause symptoms, which should alert people to seek advice from their healthcare professional.

Diagnosis

Diagnosis of anal cancer usually involves a careful history and examination, which might include anoscopy or a colonoscopy. Your healthcare provider may ask to perform a biopsy to be sure. Sometimes, people need scans, like CT, MRI or PET scans. The treatment and prognosis of anal cancer, depends on the size, location, and whether the lesion has spread. This might include surgery, chemotherapy or radiation therapy.