Purpose
To examine the prevalence and severity of faecal incontinence amongst anal cancer survivors after chemoradiotherapy.
Material and methods
Anal cancer survivors from a complete, unselected, national cohort, minimum 2-years follow-up, were invited to a cross-sectional study. The St. Mark¡¯s incontinence score was used to evaluate occurrence and degree of faecal incontinence the last four weeks. The results were compared to age- and sex-matched volunteers from the general population.
Results
Of 199 invited survivors and 1211volunteers, 66 % and 21 % , respectively, signed informed consent. The survivors had significantly higher St. Mark¡¯s score than the volunteers (mean 9.7 vs. 1.1, p < 0.001). Incontinence of stool of any degree was reported by 43 % vs. 5 % (OR 4.0, CI 2.73-6.01), and urgency was reported by 64 % vs. 6 % (OR 6.6, CI 4.38-9.90) of the survivors and volunteers, respectively. Only 29 % of those with leakage of liquid stool used constipating drugs. Survivors of locally advanced tumours had a higher incontinence score (p < 0.01).
Conclusions
Moderate to severe faecal incontinence is common amongst anal cancer survivors. Post-treatment follow-up should include the evaluation of continence, and incontinent survivors should be offered better symptom management and multidisciplinary approach if simple measures are insufficient.
