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Anal Cancer - Prevention, Prognosis

Prevention
 About 90% of anal squamous cell carcinoma occurs in patients with detectable evidence of human papilloma virus (HPV) infection.
Preventive steps of demonstrable benefit include:
Receive HPV vaccination
Avoidance of high risk behaviors which increase the risk of or facilitate the acquisition of HPV infection such as having multiple sexual partners and engaging in receptive anal intercourse
Perform anal pap testing in patients with a past history of carcinomas of the cervix, vagina, or vulva (These increase the risk of anal cancer three-fold. Detection and treatment of precancerous lesions can reduce the risk that these patients will require treatment for anal cancer in the future.)
Stop smoking, since smoking increases the risk of anal cancer
Avoid high risk behaviors for the acquisition of HIV disease (Chronic immunosuppression in men who have sex with men increases the risk of anal cancer 30-fold.)
Carefully monitor transplant recipients on immunosuppressant drugs with anal pap smears as discussed (Transplant recipients have a three-fold increased risk of anal cancer.)
Prognosis
 Anal cancer is usually curable when found localized. Early detection remains the key to long-term survival as it is in many forms of cancer. The 5-year survival rates by anal cancer stage and cell type include:
Squamous cell: 71% for stage I, 64% for stage II, 48% for stage IIIA, 43% for stage IIIB, and 21% for stage IV

Non-squamous: 59% for stage I, 53% for stage II, 38% for stage IIIA, 24% for stage IIIB, and 7% for stage IV

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