Guid to Anal Intraepithelial Neoplasia & Anal Cancer

Anal Cancer is the malignant tumor originating from the anal skin. Compared to other cancers it is a rare, relatively slow growing and slow spreading cancer, still if untreated it spreads in the body with lethal consequences.

It mostly presents as a hard growth or a non-healing hard wound. Its treatment is mainly radiotherapy and chemotherapy, sometimes surgery. Chronic infection of the anal skin with human papilloma virus cells is almost always present in anal cancer. HPV is a carcinogen virus, some strains of it cause mutation of the human cells which leads to cancer.

Anal Intraepithelial Neoplasia (AIN) I, II and III are steps on this transition of the normal anal skin towards anal cancer, with AIN I being a minor dysplastic change, while AIN III is an in situ cancer (proper cancer cells, which however cannot spread yet). AIN needs local treatment with special creams, laser, freezing or surgery.

What signs and symptoms one has with this problem?

Anal cancer is a hard irregularity in the anal opening, sometimes presents as a bleeding fissure, sometimes more looking like a wart. Anal Intraepithelial Neoplasia can also present as a wart, often however there is no obvious change compared to normal looking skin and it is only picked up on histopathology requested for a lesion considered wart or tag.

Once an AIN lesion or anal cancer was removed it is suggested for the patients to have regular follow-ups every 6-12 months to spot recurrence early on.