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There are around 5,000 new cases of anal canal cancer each year in the United States. It is of particular risk in HIV-positive populations. Many cases are related to persistent infection with human papillomavirus (HPV). The treatment of anal cancer has progressed from abdominoperineal resection mandating permanent colostomy in the 1940s through the 1970s to modern chemoradiation with sphincter preservation in around 80% of patients, even with locally advanced disease. The evolution of thedoi:10.1007/s12156-009-0006-7 fatcat:md6ckpongraf5hgjixt24mraj4