Anal Cancer: The Past, Present and Future

Curr Oncol. 2023 Mar 11;30(3):3232-3250. doi: 10.3390/curroncol30030246.


Anal cancer is a rare cancer that accounts for about 2% of all gastrointestinal tract malignancies. Among anal cancer, squamous cell cancer is the most common malignancy. The incidence of all stages of anal squamous cell cancer has been increasing. Human papillomavirus infection and immunosuppression are major risk factors for anal cancer. The management of anal cancer has evolved over the past several decades and continues to do so. Chemoradiation therapy remains the mainstay for treatment for most patients with early-stage disease, whereas systemic therapy is the primary treatment for patients with metastatic disease. Patients with persistent disease or recurrence following chemoradiation therapy are treated with salvage surgery. Access to novel cytotoxic combinations and immunotherapy has improved the outcomes of patients with advanced disease. This review provides an overview of advances in the management of anal cancer over the past two decades. This paper reviews the epidemiology, risk factors, pathology, diagnosis, and management of localized and advanced anal squamous cell cancer, highlights current knowledge gaps in the management of anal cancer, and discusses future directions.

Keywords: Anal cancer; anal canal cancer; chemotherapy; human papilloma virus; radiation; squamous cell anal cancer; surgery.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / therapeutic use
  • Anus Neoplasms* / pathology
  • Anus Neoplasms* / therapy
  • Carcinoma, Squamous Cell* / pathology
  • Chemoradiotherapy
  • Humans
  • Immunotherapy


  • Antineoplastic Agents

Grants and funding

This research received no external funding.