Fast Five Quiz: How Much Do You Know About Anal Cancer?

Elwyn C. Cabebe, MD

Disclosures

October 30, 2017

Approximately 19% of patients wait 6 months or more to seek medical care after symptom onset. Once patients do present, delayed diagnosis or misdiagnosis is unfortunately frequent; in one review, 27% of anal cancers were diagnosed as hemorrhoids on the patient's first visit to a primary care provider.

Patients with anal cancer or its precursor lesion, anal intraepithelial neoplasia, may be asymptomatic or may present with a wide range of symptoms, including the following:

  • Anal or pelvic pain and anal bleeding (approximately one half of patients)

  • Sensation of rectal mass (approximately 30%)

  • Local wetness and irritation

  • Prolapse of tissue

  • Incontinence of flatus or liquid or solid stool

  • Obstipation

Anal warts may or may not be present in a patient with anal cancer because the HPV genotypes responsible for cancer often exist together with, but are distinct from, those that typically cause anogenital warts.

Usually, an anal cancer mass has a weeping mucosal covering, with associated moisture changes in the surrounding tissue. The mass typically has a nodular texture and may be fixed to structures in the surrounding areas, such as the sphincter complex, pelvic sidewall, vagina, or coccyx area.

For more on the presentation of anal cancer, read here.

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