<prompt> The preferred initial treatment for carcinoma of the anal canal isAbdominoperineal resectionAbdominoperineal resection followed by radiotherapyRadiotherapy aloneChemoradiation  <response>: Treatment is by chemoradiotherapy in the first instance Associated with HPV More prevalent in patients with HIV infection May affect the anal verge or anal canal Lymphatic spread is to the inguinal lymph nodes Uncommon tumour, which is usually a squamous cell carcinoma Major ablative surgery is required if the above fails Ref: Bailey Love;s Sho Practice of Surgery,E25,Page-1269 