Squamous cell carcinoma of the anal canal (SCCA) is a relatively uncommon cancer, whose incidence, however, has been increasing in recent years, particularly in human immunodeficiency virus (HIV)-positive individuals. HIV-infected patients have a 28-foldhigher risk to be diagnosed with anal cancer. SCCA is more prevalent in men who have sex with men and it is strongly associated with human papilloma virus (HPV) infection types 16 and 18. The SCCA precursor, high-grade anal intraepithelial neoplasia or high-grade squamous intraepithelial lesion, has been found in about 30% of HIV-infected men who have sex with men (MSM). At diagnosis, the involvement of regional lymph nodes is present in 30-40% of SCCA cases, whereas 5-8% of patients have distant metastasis. Whenever possible, a loco-regional treatment is suggested, in order to preserve anal function and to maintain the best quality of life. In terms of prevention, HPV vaccine and early antiretroviral therapy are recommended to reduce the risk of developing anal cancer.
In this review, we summarize the main aspects of anal cancer in HIV-infected patients, with a focus on treatment and screening.