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5 to 23.7, P=0.01). There was worsening in the frequency domain in the medium term (7.23 to 14.5, P=0.02). There were no differences in any other domain or time point. Global bowel function does not appear to change following successful treatment of anal canal SCC with the modified Nigro protocol in the long term. There are some improvements in stool-related aspects and worsening in bowel movement frequency at medium-length follow-up. These findings should help surgeons counsel patients with regard to bowel function expectations for those