Management of Squamous Cell Cancer of the Anal Canal

Patient Population

Adult patients (age ≥18 years) with a primary diagnosis of biopsy-proven squamous cell cancer of the anal canal, including basaloid, cloacogenic, and transitional cell tumours.

These recommendations do not apply to patients who have previously undergone resection of their tumour. The management of patients who later develop extra-pelvic metastases is not considered in this guideline.

Intended Guideline Users

Clinicians and healthcare providers involved in the management or referral of adult patients with squamous cell cancer of the anal canal.

Research Question(s)

1. Does the addition of chemotherapy (CT) to radiotherapy (RT) improve outcome for patients with squamous cell cancer of the anal canal?
2. What are the optimal CT drugs for the treatment of patients with squamous cell cancer of the anal canal?
3. Does the use of induction CT before concurrent CT and RT improve outcome for patients with squamous cell cancer of the anal canal?
4. What is the best management for patients with squamous cell cancer of the anal canal who are human immunodeficiency virus (HIV) positive? Outcomes of interest are colostomy rate, local failure, survival, disease-free survival, acute and late adverse effects, and quality of life.