The anal canal
The anal canal is a tube at the end of your rectum that measures 1 1/2 inches in length (about 4 centimeters). Muscles (anal sphincters) that surround the anal canal relax to allow waste to leave your body.
Anal cancer is an uncommon type of cancer that occurs in the anal canal. The anal canal is a short tube at the end of your rectum through which stool leaves your body.
Anal cancer can cause signs and symptoms such as rectal bleeding and anal pain.
Most people with anal cancer are treated with a combination of chemotherapy and radiation. Though combining anal cancer treatments increases the chance of a cure, the combined treatments also increase the risk of side effects.
Anal cancer signs and symptoms include:
- Bleeding from the anus or rectum
- Pain in the area of the anus
- A mass or growth in the anal canal
- Anal itching
When to see a doctor
Talk to your doctor about any signs and symptoms that bother you, especially if you have any factors that increase your risk of anal cancer.
From Mayo Clinic to your inbox
Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health.
ErrorEmail field is required
ErrorInclude a valid email address
To provide you with the most relevant and helpful information, and understand which
information is beneficial, we may combine your email and website usage information with
other information we have about you. If you are a Mayo Clinic patient, this could
include protected health information. If we combine this information with your protected
health information, we will treat all of that information as protected health
information and will only use or disclose that information as set forth in our notice of
privacy practices. You may opt-out of email communications at any time by clicking on
the unsubscribe link in the e-mail.
Thank you for subscribing!
You'll soon start receiving the latest Mayo Clinic health information you requested in your inbox.
Sorry something went wrong with your subscription
Please, try again in a couple of minutes
Anal cancer forms when a genetic mutation turns normal, healthy cells into abnormal cells. Healthy cells grow and multiply at a set rate, eventually dying at a set time. Abnormal cells grow and multiply out of control, and they don't die. The accumulating abnormal cells form a mass (tumor). Cancer cells invade nearby tissues and can separate from an initial tumor to spread elsewhere in the body (metastasize).
Anal cancer is closely related to a sexually transmitted infection called human papillomavirus (HPV). Evidence of HPV is detected in the majority of anal cancers. HPV is thought to be the most common cause of anal cancers.
Several factors have been found to increase the risk of anal cancer, including:
- Older age. Most cases of anal cancer occur in people age 50 and older.
- Many sexual partners. People who have many sexual partners over their lifetimes have a greater risk of anal cancer.
- Anal sex. People who engage in receptive anal sex have an increased risk of anal cancer.
- Smoking. Smoking cigarettes may increase your risk of anal cancer.
- History of cancer. Those who have had cervical, vulvar or vaginal cancer have an increased risk of anal cancer.
- Human papillomavirus (HPV). HPV infection increases your risk of several cancers, including anal cancer and cervical cancer. HPV infection is a sexually transmitted infection that can also cause genital warts.
- Drugs or conditions that suppress your immune system. People who take drugs to suppress their immune systems (immunosuppressive drugs), including people who have received organ transplants, may have an increased risk of anal cancer. HIV — the virus that causes AIDS — suppresses the immune system and increases the risk of anal cancer.
Anal cancer rarely spreads (metastasizes) to distant parts of the body. Only a small percentage of tumors are found to have spread, but those that do are especially difficult to treat. Anal cancer that metastasizes most commonly spreads to the liver and the lungs.
There is no sure way to prevent anal cancer. To reduce your risk of anal cancer:
- Practice safer sex. Practicing safe sex may help prevent HPV and HIV, two sexually transmitted viruses that may increase your risk of anal cancer. If you choose to have anal sex, use condoms.
- Get vaccinated against HPV. A vaccine to protect against HPV infection is available. It's recommended for adolescents, including both boys and girls, but may be given to adults, too.
- Stop smoking. Smoking increases your risk of anal cancer. Don't start smoking. Stop if you currently smoke.
Anal cancer care at Mayo Clinic
Aug. 12, 2021
- Deng GE, et al. Evidence-based clinical practice guidelines for integrative oncology: Complementary therapies and botanicals. Journal of the Society for Integrative Oncology. 2009;7:85.
- Anal carcinoma. Plymouth Meeting, Pa.: National Comprehensive Cancer Network. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed April 1, 2019.
- Anal cancer treatment (PDQ) – Health professional version. National Cancer Institute. https://www.cancer.gov/types/anal/hp/anal-prevention-pdq. Accessed July 5, 2019.
- Gardasil 9 (prescribing information). Whitehouse Station, N.J.: Merck & Co. Inc.; 2018. https://www.gardasil9.com. Accessed June 2, 2019.
- Niederhuber JE, et al., eds. Cancer of the anal canal. In: Abeloff's Clinical Oncology. 6th ed. Philadelphia, Pa.: Elsevier; 2020. https://www.clinicalkey.com. Accessed April 1, 2019.
- Taking time: Support for people with cancer. National Cancer Institute. https://www.cancer.gov/publications/patient-education/taking-time. Accessed June 2, 2019.
- Palliative care. Fort Washington, Pa.: National Comprehensive Cancer Network. http://www.nccn.org/professionals/physician_gls/f_guidelines.asp. Accessed May 5, 2016.
- Warner KJ. Allscripts EPSi. Mayo Clinic, Rochester, Minn. May 7, 2019.
- Amin MB, et al., eds. Anus. In: AJCC Cancer Staging Manual. 8th ed. New York, NY: Springer; 2017.