Anal cancer
Structure and Disease: Anal Cancer Explained
Modified according to the Oncology Guidelines Programme1
Anal cancer, medically referred to as “anal carcinoma,” is a malignant tumor of the anus. The anus, also called the rectal opening, is where stool exits the body. A distinction is made between tumors of the anal canal and those of the anal margin.2
Anal cancer is a rare disease affecting approximately 1.3 to 2.3 people per 100,000 annually - women more often than men.1 It typically occurs between the ages of 50 and 70.2
Because anal cancer is relatively rare, it is still overlooked even though cases are steadily increasing.1 That's why it's so important to address any symptoms in and around the anus early, to enable better early detection.
Information about HPV
The importance of HPV vaccination
Nearly all sexually active people will be infected with the Human Papillomavirus (HPV) at some point in their lives. In most cases, HPV causes no harm and clears on its own. However, some types of HPV can lead to genital warts or, in the worst case, cancer of the cervix, vulva, vagina, penis, throat or anal cancer. 2,3
Vaccination is a safe and effective way to protect against the most common high-risk types of HPV. It is ideally administered before potential exposure to the virus, meaning before the first sexual contact. HPV vaccination at a later stage can still reduce the risk of HPV infection and HPV-related diseases and also contributes to improving herd immunity. 3,4
Regular Pap tests (for cervical changes) and HPV tests
Screening is essential for early detection of cell changes or infections that may develop into cancer. A Pap test checks for abnormalities in cervical cells, while an HPV test detects the presence of high-risk types of the virus. Even individuals who have received the HPV vaccine should continue to undergo regular screening. 5,6
What are the symptoms?
Anal carcinoma can present in very different ways. Unfortunately, the symptoms are often non-specific and resemble those of other, less serious conditions such as hemorrhoids.7
Typical symptoms2
- Bleeding in the anal area
- Blood in the stool
- Pain during bowel movements
- Itching in the anal area
- Palpable lumps
- A foreign body sensation (changes in the skin around the anus)
- Enlarged lymph nodes in the groin
Important
Many affected individuals hesitate to seek medical advice due to uncertainty or because anal symptoms are considered taboo. As a result, they often visit a doctor late, which can delay diagnosis and treatment.8
Image generated for illustrative purposes only.
Does not depict real patients or healthcare professionals. Image generated for illustrative purposes only. Does not depict real patients or healthcare professionals.
References
- Robert Koch-Institut. Krebs in Deutschland. https://www.krebsdaten.de/Krebs/DE/Content/Publikationen/Krebs_in_Deutschland/krebs_in_deutschland_2023.pdf?__blob=publicationFile (last accessed on 09.02.2026).
- Leitlinienprogramm Onkologie. Patientenleitlinie Analkarzinom. https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Patientenleitlinien/Patientenleitlinie_Analkrebs_167v100.pdf (last accessed on 09.02.2026).
- Williamson AL. Viruses. 2023;15(7):1440. doi: 10.3390/v15071440.
- Illah O, et al. Diagnostics. 2023;13(2):243. doi: 10.3390/diagnostics13020243.
- Chrysostomou AC, et al. Viruses. 2018;10(12):729. doi: 10.3390/v10120729.
- Arbyn M, et al. Ann Oncol. 2010;21(3):448–458. doi: 10.1093/annonc/mdp471.
- Bundesministerium für Gesundheit. Hämorrhoiden. https://gesund.bund.de/haemorrhoiden (last accessed on 09.02.2026).
- Siegel R, et al. Dtsch Arztebl Int 2021;118:217-24. doi: 10.3238/arztebl.m2021.0027.