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Colon Cancer

Anal Cancer Risk with Fistula

11/18/2011

Question:

I have a four-year-old perianal fistula due to Crohn`s disease. An MRI showed that it is a 10 cm long by 7-8 mm in width. I was told it is a very long track and is a mature fistula.

Am I at any higher risk for anal cancer as time goes on due to the fistula?

Thank you

Answer:

Anal cancer is uncommon, but perianal fistulae from Crohn's disease do seem to be associated with an increased risk for anal cancer. The cause of this increased risk is not known. It is speculated that chronic inflammation from the fistula increases risk. Generally, the few cases that have been reported in the literature occurred in patients who had had a fistula for a number of years. Smoking is also a risk factor for anal cancer, so if you are a smoker I would strongly encourage you to quit smoking (this would also probably help improve the Crohn's disease as well). Depending on what treatments you may have already tried, there may be medications, procedures, or surgery that could potentially be used to treat the fistula.

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Response by:

Linda Cheng Cummings, MD, MS Linda Cheng Cummings, MD, MS
Assistant Professor of Medicine
School of Medicine
Case Western Reserve University