Epidemiology of penile cancer
Introduction
Penile cancer is a rare genital malignancy and most of the lesions are histologically classified as squamous cell carcinomas (SCCs). Although it is a rare tumor in developed countries, the incidence of penile cancer is significantly higher in developing countries.1 In this section we review the epidemiology of penile cancer in different population groups globally and also examine predisposing risk factors.
Section snippets
Epidemiological trends
The total number of penile cancers globally has been estimated to be 26,000 cases per year.2 The incidence is much higher in some areas of Asia, Africa, and South America as compared with Western Europe and North America. This may be partly due to differences in socioeconomic conditions and religious practices.3, 4 For example, in Israeli Jews the protective effect of neonatal circumcision leads to the extremely low incidence of 0.1 in 100,000.5 It has been observed that even in developing
Summary
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Hispanic men have a higher incidence of penile cancer compared with non-Hispanic men in the USA. Lower circumcision rates within the Hispanic ethnic groups may explain this trend.
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Socioeconomic variation between ethnic groups could also reflect differences in sexual practises and HPV exposure. The earlier age of presentation in the Hispanics group may reflect earlier exposure to HPV.
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Penile cancer incidence increases with age, with the highest rate being between 50 and 70 years. This is
Risk factors
A number of risk factors are associated with a higher incidence of penile cancer. The two most important are HPV infection and phimosis. In this section we will expand on these and also discuss other factors such as lichen sclerosis, tobacco use, penile trauma, sexual history, and marital status as well as ultraviolet A photochemotherapy (PUVA).
Conclusion
The incidence of penile cancer is higher in developing countries as compared with developed countries; however, there is a significant variation among ethnic groups. This reflects the importance of socioeconomic status and religious practices in the etiology of penile cancer.
The key risk factors that have been identified include HPV status, phimosis, tobacco use, penile trauma, and PUVA therapy (Fig 7). Measures to counter these risk factors must be taken in order to address the global
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