Background This study aims to systematically explore the contemporary global incidence of anal cancer, stratified by its histological and anatomical subtypes, utilizing international and national cancer registries.

Methods Data on anal cancer incidence by histological (adenocarcinoma (AD) or squamous cell carcinoma (SCCr)) and anatomical subtypes (anus or anorectum) in 2022 were estimated from the Global Cancer Observatory (GLOBOCAN) and Cancer Incidence in Five Continents (CI5) XII. Age-standardised incidence rates were calculated using the world standard population.

Results The estimated global incidence of anal cancer in 2022 was 0.54 per 100,000 individuals, totaling 54,306 cases. SCCr was the most common histological subtype, accounting for 62.8% of cases, compared to 32.8% for AD. The majority (79.8%) of anal cancers were located in the anus, while 20.2% were in the anorectum. A notable disparity was observed in the proportion of SCCr between males (51.1%) and females (72.0%). The older population exhibited a slightly higher proportion of SCCr occurrence (65.9%) compared to the younger generation (61.1%). Regionally, SCCr was most prevalent in Western Europe (92.3%), Northern Europe (88.5%), and North America (87.9%), while AD prevalence was highest in Eastern Asia (73.2%) and Southeast Asia (60.7%).

Conclusions This study provides a comprehensive analysis of the global burden of anal cancer, highlighting the distinct epidemiological patterns of its histological and anatomical subtypes. These findings can inform targeted prevention and management strategies for this malignancy.