肛门癌(AC)是一种罕见的疾病，来自发展中国家的证据很少。我们进行了一项以人群为基础的队列研究，以探讨肿瘤、患者和社会健康决定因素与采用化学放射联合治疗（CRT）治疗的AC的治疗效果之间的关系。我们从The Fundação Oncocentro de São Paulo数据库中，筛选出1999年至2020年被诊断为AC的患者。只有采用CRT治疗的I-III期AC患者被纳入研究。年龄、性别、肿瘤分类（T）、淋巴结分类（N）、教育水平、医疗实践、放疗时间、组织学和治疗本地数据等因素被提取。我们采用Cox比例风险模型，使用危险比和95%的置信区间检验肿瘤、患者和社会因素与总体生存率（OS）和癌症特异性生存率（CSS）之间的关系。 研究评估了1462名患者，中位随访时间为72个月，5/10年的OS和CSS分别为61%/46%和67%/60%。在单因素分析中，T分类、N分类、性别、医疗实践和教育水平与OS和CSS存在关联，p<0.05。在多因素分析中，女性、T1/2分类、N0分类和私人服务与OS有独立关联，P<0.05。对于CSS而言，女性、T1/2分类、私人服务和N0分类仍具有显著关联，p<0.05。采用CRT治疗的AC患者，OS和CSS的效果令人满意，肿瘤、患者和社会决定因素都会影响治疗效果。这些数据有助于减轻社会扭曲对AC生存率的影响。 版权所有©2023。Elsevier Inc. 发表。

Anal cancer (AC) is a rare disease with scarce evidence from developing countries. We performed a population-based cohort study to investigate the relationship between tumor, patient, and social determinants of health with treatment outcomes of AC treated by chemoradiation (CRT).Patients diagnosed with AC from 1999 to 2020 were identified from The Fundação Oncocentro de São Paulo database. Only patients with AC staged I-III treated by CRT were included. Age, gender, Tumor category (T), Nodal category (N), education level, practice setting, time to radiotherapy, histology, and treatment local data were extracted. With Cox proportional hazard model, the hazard ratio and 95% CI was used to test the relationship between tumor, patient, and social factors with overall survival (OS) and cancer-specific survival (CSS).With 1,462 patients assessed, the median follow-up was 72 months, and the OS and CSS at 5/10 years were 61%/46% and 67%/60%, respectively. In the univariate analysis, T category, N category, gender, practice setting, and educational level were associated with OS and CSS, p<0.05. In the multivariate analysis, female, T1/2 category, N0 category, and private service were independently associated with OS, p<0.05. For CSS, female, T1/2 category, private service, and N0 category, remained significant, p<0.05.CRT produced satisfactory rates of OS and CSS in patients with AC with tumor, patient, and social determinants of health influencing the outcomes. These data could help mitigate the effects of social distortions on the survival of AC.Copyright © 2023. Published by Elsevier Inc.