Mortality Predictions for Men and Women Diagnosed with Anal Canal Squamous Cell Carcinoma in the United States

Abstract

ABSTRACTObjectiveStudies have concluded that treatments for patients with anal cancer vary based on their age, sex, and race. We examined gender-specific differences in mortality and overall survival for patients with squamous cell carcinoma (SCC) of the anal canal (AC), based on differences in treatment, stage and demographic factors.MethodSEER’s retrospective cohort dataset was used to review all patients diagnosed with SCC of the AC between 2000 and 2018. We analyzed survival by sub-distributed Cox models and estimated overall survival probabilities through nomograms based on cancer treatments, tumor characteristics, and demographic dataResultsIn the study, 24,892 patients with SCC in the AC had a median survival time of 43 months (IQR: 16-97). However, males (median 38.0 months, IQR: 13.0-92.0) had significantly shorter median survival times than females (median 46.0 months, IQR: 17-100). There were 12% of patients in metastatic stages, with females (70.3%) receiving more treatments than males (29.7%). The survival rate of patients with SCC of the AC who underwent radiation treatment was significantly higher (HR 0.72, 95% CI: 0.65-0.80, p<0.001). Moreover, compared to those without surgery on the primary site, those undergoing surgery on the primary site had a 49% lower mortality rate (HR 0.51; 95% CI: 0.45 to 0.56, p0.001). According to the study, the overall survival probability at 5 and 10 years for patients who received chemotherapy on primary sites was about 90%, compared to only 40% and 22% for those who did not receive chemotherapy. Surgical intervention yielded similar results, but radiation therapy did not significantly improve survival rates.ConclusionCompared with men, women with SCC of the AC have a higher survival rate, and younger patients tend to live longer. The factors negatively affecting survival were increasing age, non-whites, divorced / separated / widowed, and advanced stages of cancer. A significant increase in survival was seen after surgery and chemotherapy for SCC, while radiation had little effect on survival.