An update on anal cancer diagnosis and treatment.

There have been major changes in the treatment of anal cancer in past few years with chemoradiotherapy (CRT) is now considered the first line treatment and residual or recurrent disease is best treated by salvage anorectal excision. Anal cancer is now staged clinically with emphasis on tumour size, lymph node status and the presence or absence of metastases. Pathological staging systems of resection specimens were historically validated when surgery was the primary treatment and are therefore in need of revision.