Introduction Most common type is basaloid cancer more frequent in women located above dentate line Second most common is squamous cell CA more frequent in men who have anal intercourse associated with HPV 16, 18 located in anal canal Risk factors fistulas abscess infections Crohn's disease Presentation Symptoms 25% asymptomatic anal bleeding pain mucus per rectum pruritus Evaluation Anoscope Biopsy Treatment Surgical excision