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Benign Lesions Linked to Higher Risk of Anal Cancer

Hemorrhoids do not appear to be a risk factor

THURSDAY, April 20 (HealthDay News) -- There is a significant link between benign inflammatory anal lesions and long-term risk of anal cancer, although hemorrhoids don't appear to be a risk factor, according to a study in the May issue of Gut.

Weimin Ye, M.D., Ph.D., of the Karolinska Institute in Stockholm, Sweden, and colleagues conducted a register-based retrospective cohort study comprising 45,186 patients who had been hospitalized for inflammatory anal lesions, including anal fissures, fistulas and perianal abscesses, and 79,808 hemorrhoid patients. Incidences of colorectal cancers and anal squamous cell carcinoma were also identified.

Among patients with inflammatory lesions, there was a peak of 3.3 in the standardized incidence ratio (SIR) of anal cancer in the first three years of follow-up, at which point the SIR leveled off and remained at this level throughout follow-up to year 37. At one year there was a similar peak in SIR among hemorrhoid patients, but after that, it declined until it was close to unity at the end of follow-up.

"Clinicians who are responsible for treatment of benign anal lesions should be aware of the high possibility of misdiagnosis of anal cancer," the authors write. "Given the relative rarity of anal cancer and the only moderate excess long-term risk, however, regular surveillance for anal cancer among patients with benign inflammatory anal lesions is not justifiable."

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