Anal cancer is a rare type of cancer. It generally has a good outlook (82% relative survival rate) when it’s caught in the early stages. But that outlook drops if the cancer has spread to other parts of your body.

Anal cancer is rare compared with colon cancer or rectal cancer. The American Cancer Society (ACS) estimates that about 9,760 people will receive a diagnosis with anal cancer in the United States in 2023.

The lifetime risk of developing anal cancer is about 1 in 500. It’s most common in people who have risk factors, such as:

On average, people with anal cancer live at least 5 years about 69% as often as people without anal cancer. The stage of your cancer at the time of your diagnosis strongly influences your outlook.

Read on to learn more about the outlook for anal cancer and the factors that affect outlook.

Language Matters

We use “women” and “men” in this article to reflect the terms that have been historically used to gender people. But your gender identity may not align with how your body responds to this disease. Your doctor can better help you understand how your specific circumstances will translate into diagnosis, symptoms, treatment, and outlook.

Your cancer stage at the time of your diagnosis is one of the most important factors that determine your chances of survival. Anal cancer has the best outlook when it hasn’t spread to distant parts of your body.

Doctors use several staging systems for anal cancer. The ACS breaks cancer into three stages for reporting survival rates. People in the United States with anal cancer had the following 5-year relative survival rates from 2011 to 2017:

Cancer stageDescription5-year relative survival rate
Localizedno spread outside the anal area82%
Regionalspread to nearby lymph nodes or structures66%
Distantspread to distant areas like the liver or lungs35%
Overallall stages combined69%

The 5-year relative survival rate is a measure of how many people with the cancer are alive 5 years later compared with people without the cancer.

More than 90% of anal cancers are squamous cell carcinoma. This type of cancer starts in squamous cells that line your anus. Its survival rate is similar to anal cancer in general since it makes up the majority of these cancers.

Rarer types of anal cancer include:

  • Adenocarcinoma: Adenocarcinoma of the anal canal develops in glandular cells and tends to be more aggressive than squamous cell carcinoma. In a 2019 review of 1,729 cases, researchers reported a 5-year survival rate of 55%.
  • Basal cell carcinoma: Basal cell carcinoma starts in the cells that produce new skin cells. Its survival rate isn’t well established due to its rarity and the small sample sizes of available studies.
  • Melanoma: Melanoma develops in skin cells that produce pigment. Melanoma of the anal canal has a very poor outlook with a 5-year survival rate of around 20%.
  • Gastrointestinal stromal tumor: Gastrointestinal stromal tumors develop in special cells in the wall of your gastrointestinal tract. They’re extremely rare in the anal canal. Gastrointestinal stromal tumors in general have a 5-year relative survival rate of 83%.

Other factors that can influence the outlook of anal cancer include the following.

Cancer location

Anal cancer is divided into two groups depending on where the cancer begins:

  • cancers of the anal canal develop in the passage that leads from the outer part of your anus to your rectum
  • cancers of the perianal area develop on the skin that makes up the outer part of your anus

Cancer of the perianal skin tends to be diagnosed at an earlier stage, which also means it tends to have a better outlook.

Male sex and spread to lymph nodes

In a 2022 review of studies, researchers found that male sex and cancer spread to lymph nodes typically led to worse overall survival and a higher chance of treatment failure.

Overall health and younger age

People with a diagnosis of anal cancer at a younger age tend to have a better chance of survival than people who received a diagnosis at a later age. In a 2021 study, researchers found that being under the age of 60 was associated with a 3.24 times higher chance of survival in 372 people with HIV-negative localized or regional anal cancer.

Most studies in the 2022 review of studies identified better performance status as a factor linked to a better outlook. Performance status is a measure of how well you can undergo your everyday activities.

HPV status

In the 2022 review of studies, researchers found that lower detectable levels of HPV 16 were associated with a better outcome in 2 out of 3 of the studies they reviewed. HPV 16 is a high risk type of HPV linked to 50% of cervical cancers.

Access to healthcare

It’s well established that access to quality healthcare is linked to better outcomes in people with cancer due to improved time to diagnosis and treatment. People with barriers to treatment, such as financial hardship or who live in areas with difficult access to healthcare services, may have more difficulty receiving a timely diagnosis.

Many people are embarrassed to visit their doctor when they have problems with their anus or lower gastrointestinal tract. However, it’s important to seek medical attention as soon as possible if you suspect you may have anal cancer since the cancer will only get worse with time.

Anal cancer is a rare type of cancer. It generally has a good outlook when it’s caught in the early stages but becomes more difficult to treat if it spreads to other parts of your body.

The stage of your cancer is one of the primary factors that determines your survival rate. Other factors like your age, overall health, and the type of cancer you have can also influence your chances of survival.