skip to main content

Anal SCC Chemoradiation — SCE Infectious Diseases MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHIV MedicineAnal SCC ChemoradiationSCE Infectious Diseases

A 40-year-old man with HIV on effective ART develops squamous cell carcinoma of the anus. He is referred to colorectal surgery. What is the standard treatment for localised anal SCC?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Concurrent chemoradiotherapy (Mitomycin C plus 5-Fluorouracil with radiotherapy — the Nigro protocol) — this is curative intent treatment; abdominoperineal resection is reserved for treatment failure

Anal SCC (regardless of HIV status) is treated with concurrent chemoradiotherapy (the Nigro protocol: Mitomycin C plus 5-FU with radical radiotherapy) as definitive first-line treatment. Complete response rates are 80–90%. Abdominoperineal resection (APR — permanent colostomy) is reserved for residual/recurrent disease after chemoradiation. In well-controlled HIV, treatment outcomes are approaching HIV-negative benchmarks. ART must be maintained throughout. PJP prophylaxis and G-CSF support may be needed during chemotherapy.

Reference: NICE NG36 2021 – Anal cancer; BHIVA 2022 – HIV-associated malignancy; Nigro Protocol