Carcinoma of the anal canal accounts for 1.5 percent of digestive-systemcancers in the United States, with an estimated 3400 new casesin 2000.1 Thirty years ago, anal cancer was believed to be causedby chronic, local inflammation of the perianal area2,3 and wastreated with an abdominoperineal resection, necessitating apermanent colostomy.4 As the result of a series of epidemiologicstudies, it is now apparent that the development of anal canceris associated with infection by human papillomavirus, whichis usually sexually transmitted. Moreover, in the majority ofpatients, the condition can be cured by concurrent chemotherapyand radiation . . . [Full Text of this Article]
Anatomical Features, Histologic Findings, and Presentation
Epidemiologic Associations
Physical Trauma or Inflammation
Sexual Activity
Human Papillomavirus
Immunosuppression
HIV Infection
Smoking
Surgical Treatment
Primary Radiation Therapy
Combination Therapy
Results of Randomized Trials
The Role of Mitomycin
The Potential Role of Cisplatin
Treatment of Persistent and Recurrent Disease
Summary
Source Information
From the Department of Adult Oncology, DanaFarber Cancer Institute (D.P.R., R.J.M.); the Division of HematologyOncology and the Department of Medicine (D.P.R., R.J.M.) and the Department of Pathology (C.C.C.), Massachusetts General Hospital; the Department of Medicine, Brigham and Women's Hospital (D.P.R., R.J.M.); and Harvard Medical School (D.P.R., C.C.C., R.J.M.) all in Boston.
Address reprint requests to Dr. Mayer at the DanaFarber Cancer Institute, 44 Binney St., Boston, MA 02115.
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