Anal carcinoma in a tropical low socio-economic population in the new millennium: What has changed?

The paper is a retrospective look at the clinicopathological presentation of carcinoma of the anal canal in a tertiary health institution in Nigeria. Sixty-five patients were diagnosed with anal carcinoma over a five-year period (2002-2006) from a total of 394 patients who had malignancies of the colon, rectum and anus. The male: female ratio was 1.2: 1 showing a slight male predominance; the average age was 48 years; tenesmus, bleeding per rectum and anal pain were the most common presenting features. None of the patients tested positive to HIV during the duration of their stay in hospital. The most predominant histopathological subtype was adenocarcinoma - a departure from the hitherto squamous cell cancer dominance. Thus, only a few patients benefited from chemo-radiation; the majority had abdominoperineal resection while quite a significant proportion of patients (27.7%) declined any form of treatment for socio-cultural reasons.