Previous studies have found that high pretreatment CRP/Alb ratio is associated with poor prognosis in esophageal cancer, gastric cancer, ovarian cancer, pancreatic cancer, hepatocellular carcinoma and anal squamous cell carcinoma [17–23] In addition, one study report that postoperative CRP/Alb ratio was an independent prognostic factor for surgical complications and had a higher diagnostic accuracy than CRP alone of gastric cancer [24]. Here, CRP is linked to anal squamous cell carcinoma.