Abstract
One hundred fifty-six consecutive cases of carcinoma of the anal canal and margin diagnosed between 1959 and 1986 were reviewed. There were 27 cases between 1959 and 1967, 41 between 1968 and 1976, and 88 between 1977 and 1986. Although the female-to-male ratio remained constant at 1.5∶1, a high-risk group emerged, consisting of male patients with admitted homosexuality, bisexuality, or a history of anal condylomata acuminata. During the earliest period, 8 percent of male patients were in this group; this subset rose to 72 percent during the latest period (P<.05). While the number of anal margin cancers has decreased, there has been a steady rise in the number of anal canal andin situ carcinomas, especially in the high-risk group.
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References
Silverberg E, Lubera J. Cancer Statistics 1987 CA 1987;37:2–19.
Cattell RB, Williams AC. Epidermoid cancer of the anus and rectum. Arch Surg 1943;46:336–49
Morson BC. The pathology and results of treatment of cancer of the alal region. Proc R Soc Med 1959;52:S117–8.
Richards JC, Beahrs OH, Woolner LB. Squamous cell carcinoma of the anus, anal canal and rectum in 109 patients. Surg Gynecol Obstet 1962;114:474–82.
Sweet RH. Results of treatment of epidermoid carcinoma of the anus and rectum. Surg Gynecol Obstet 1947;84:967–72.
Goligher JC. Carcinoma of the anal canal and anus. In: Surgery of the anus, rectum and colon. 5th ed. London: Balliere Tindall, 1984:780–93.
Klotz RG Jr, Pamukcoglu T, Souilliard DH. Transitional cloacogenic carcinoma of the anal canal. Clinical pathologic study of three hundred seventy-three cases. Cancer 1967;20:1727–45.
Stearns M, Quan S. Epidermoid carcinoma of the anorectum. Surg Gynecol Obstet 1970;131:953–7.
Bowman BM, Moertel CG, O'Connell MJ, et al. Carcinoma of the anal canal: a clinical and pathologic study of 188 cases. Cancer 1984;54:114–25.
Salmon RJ, Zafrani B, Labib A, Asselain B, Girodet J. Prognosis of cloacogenic and squamous cancers of the anal canal. Dis Colon Rectum 1986;29:336–40.
Nigro ND. An evaluation of combined therapy for squamous cell cancer of the anal canal. Dis Colon Rectum 1984;27:763–6.
Greenall MJ, Quan SH, Stearns MW, Urmacher C, DeCosse JJ. Epidermoid cance of the anal margin: pathologic features, treatment, and clinical results. Am J Surg 1985;149:95–101
Siegal B, Cohen D, Jacob ET Surgical treatment of anorectal melanomas. Am J Surg 1983;146:336–8.
Angeras U, Jonsson N, Jonsson PE. Primary anorectal malignant melanoma. J Surg Oncol 1983;22:261–4.
Parks TG. Mucus-secreting adenocarcinoma of anal gland origin. Br J Surg 1970;57:434–6.
Zaren HA, Delone FX, Lerner HJ. Carcinoma of the anal gland: case report and review of the literature. J Surg Oncol 1983;23: 250–4.
Morson BC, Quoted by Wellman KF. Adenocarcinoma of anal duct origin. Can J Surg. 1962;5:311–8.
Hughes E, Cuthbertson AM, Killingback MK. Squamous cell carcinoma of the anal margin and anal canal. In: Colorectal surgery. New York: Churchill-Livingstone, 1983:413–20.
Walz B. Anal carcinoma. In: Kodner IJ, Fry RD, Roe JP (eds). Colon, rectal and anal surgery. St. Louis: CV Mosby, 1985;198–203.
Sayfan J, Halevy J, Oland J, Reif R. Bowen's disease: a rare surprise in minor anorectal surgery. Coloproctology 1986;8:372–4.
Croxson T, Chabon AB, Rorat E, Barash IM. Intraepithelial carcinoma of the anus in homosexual men. Dis Colon Rectum 1984;27:325–30.
Bowen JT. Precancerous dermatoses: a study of two cases of chronic atypical epithelial proliferation. J Cutan Dis 1912;30: 241–55.
Strauss RJ, Fazio VW. Bowen's disease of the anal and perianal area: a report and analysis of twelve cases. Am J Surg 1979;137: 231–4.
Ramos R, Salinas H, Tucker L. Conservative approach to the treatment of Bowen's disease of the anus. Dis Colon Rectum 1983;26:712–5.
Lee SH, McGregor DH, Kuziez MN. Malignant transformation of perianal condyloma acuminatum: a case report with review of the literature. Dis Colon Rectum 1981;24:462–7.
Gal AA, Meyer PR, Taylor CR. Papillomavirus antigens in anorectal condyloma and carcinoma in homosexual men. JAMA 1987;257:337–40.
Wexner SD, Smithy WB, Milsom JW, Dailey TH. The surgical management of anorectal diseases in AIDS and pre-AIDS patients. Dis Colon Rectum 1986;29:719–23.
Golden GT, Horsley JS III. Surgical management of epidermoid carcinoma of the anus. Am J Surg 1976;131:275–80.
Greenall MJ, Quan SH, DeCosse JJ. Epidermoid cancer of the anus. Br J Surg 1985;72:S97–103.
Merlini M, Eckert P. Malignant tumors of the anus: a study of 106 cases. Am J Surg 1985;150:370–2.
Ajlouni M, Mahrt D, Milad MP. Review of recent experience in the treatment of carcinoma of the anal canal. Am J Clin Oncol 1984;7:687–91.
Salmon RJ, Fenton J, Asselain B et al. Treatment of epidermoid anal canal cancer. Am J Surg 1984;147:43–8.
Corman ML. Malignant tumors of the anal canal. In: Colon and rectal surgery. Philadelphia: B Lippincott, 1984;413–28.
McConell EM. Squamous carcinoma of the anus: a review of 96 cases. Br J Surg 1970;57:89–92.
Nash G, Allen W, Nash S. Atypical lesions of the anal mucosa in homosexual men. JAMA 1986;256:873–6.
Sohn N, Robilotti JG. The gay bowel syndrome: a review of colonic and rectal conditions in 200 male homosexuals. Am J Gastroenterol 1977;67:478–84.
Cooper HS, Patchefsky AS, Marks G. Cloacogenic carcinoma of the anorectum in homosexual men: an observation of four cases. Dis Colon Rectum 1979;22:557–8.
Li FP, Osborn D, Cronin CM. Anorectal squamous carcinoma in two homosexual men. Lancet 1982;2:391.
Cantril ST, Green JP, Schall GL, Schaupp WC. Primary radiation therapy in the treatment of anal carcinoma. Int J Radiat Oncol Biol Phys 1983;9:1271–8.
Daling JR, Weiss NS, Klopfenstein LL, Cochran LE, Chow WH, Daifuku R. Correlates of homosexual behavior and the incidence of anal cancer. JAMA 1982;247:1988–90.
Austin DF. Etiological clues from descriptive epidemiology: squamous carcinoma of the rectum or anus. In: Henderson BE, ed. Third Symposium on Epidemiology and Cancer Registries in the Pacific Basin, monograph 62. Bethesda: National Cancer Institute, 1982:89–90.
Peters RK, Mack TM. Patterns of anal carcinoma by gender and marital status in Los Angeles County. Br J Cancer 1983;48:629–36.
Peters RK, Mack TM, Bernstein L. Parallels in the epidemiology of selected anogenital carcinomas. JNCI 1984;72:609–15.
Syrjanen KJ. Human papillomavirus (HPV) infections of the female genital tract and their associations with intraepithelial neoplasia and squamous cell carcinoma. In: Sommers SC, Rosen PP, Fechner RE, eds. Pathology annual. Norwalk: Appleton-Century-Crofts, 1986:53–89.
Brescia RJ, Jenson B, Lancaster WD, Kurman RJ. The role of human papillomavirus in the pathogenesis and histologic classification of precancerous lesions of the cervix. Hum Pathol 1986;17:555–9.
Connors RC, Ackerman AB. Histologic pseudomalignancies of the skin. Arch Dermatol 1976;112:1767–80.
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Read at the meeting of the American Society of Colon and Rectal Surgeons, Washington, D.C., April 5 to 10, 1987.
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Wexner, S.D., Milsom, J.W. & Dailey, T.H. The demographics of anal cancers are changing identification of a high-risk population. Dis Colon Rectum 30, 942–946 (1987). https://doi.org/10.1007/BF02554281
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DOI: https://doi.org/10.1007/BF02554281