Abstract
BackgroundIncidence of anal carcinoma (AC) is increasing and timely diagnosis is critical for efficient therapy. However, there is a paucity of recent studies addressing clinical symptoms and physical findings of anal carcinoma.MethodsWe performed a retrospective study reviewing history, symptoms and physical findings from 86 patients with newly diagnosed AC. We analyzed frequency of symptoms and physical findings according to T and TNM stage and their predictive value regarding tumor stage.ResultsMost patients presented with T2 (37 %) or T3 (29 %) cancer. 85 of 86 patients were symptomatic with anal bleeding (78 %), anal/perianal pain (63 %), weight loss (31 %) and foreign body sensation (22 %). 95 % of patients had ≥1 finding on physical examination including a visible tumor, palpable resistance and pain/blood during digital rectal examination. Patients with locally advanced disease (T3/T4) presented with more symptoms (p < 0.01) and more physical findings (p = 0.04) than patients with T1/T2 disease. On multivariate regression analysis perianal pain, painful defecation and weight loss were significantly associated with T3/T4 disease.ConclusionClinical symptoms and physical findings are present in nearly all AC patients. Pain referred to the perianal region, painful defecation and weight loss have predictive value for locally advanced disease.Electronic supplementary materialThe online version of this article (doi:10.1186/s12876-016-0461-0) contains supplementary material, which is available to authorized users.
Highlights
Incidence of anal carcinoma (AC) is increasing and timely diagnosis is critical for efficient therapy
Most patients presented with T2 (37 %) or T3 (29 %) cancer. 85 of 86 patients were symptomatic with anal bleeding (78 %), anal/perianal pain (63 %), weight loss (31 %) and foreign body sensation (22 %). 95 % of patients had ≥1 finding on physical examination including a visible tumor, palpable resistance and pain/blood during digital rectal examination
Clinical symptoms and physical findings are present in most AC patients
Summary
Incidence of anal carcinoma (AC) is increasing and timely diagnosis is critical for efficient therapy. There is a paucity of recent studies addressing clinical symptoms and physical findings of anal carcinoma. The increasing incidence of anal carcinoma might reflect changes in one or more of the risk factors mentioned above and might follow an increase in infection rates of HPV and HIV. Diagnosis of anal carcinoma is critical, since for the treatment of early cancer highly effective and function preserving radio-(chemo) therapy is available. An association of symptoms or findings with early or an advanced disease has to the best of our knowledge
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