Burden of invasive squamous cell carcinoma of the penis in the United States, 1998-2003

Abstract

BACKGROUND Invasive squamous cell carcinoma (SCC) of the penis is rare in the United States. Although human papillomavirus (HPV) infection is an established etiologic agent in at least 40% of penile SCCs, relatively little is known about the epidemiology of this malignancy. METHODS Population-based data from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program, the Centers for Disease Control and Prevention's National Program for Cancer Registries, and the National Center for Health Statistics were used to examine invasive penile SCC incidence and mortality in the United States. SEER data were used to examine treatment of penile SCC. RESULTS From 1998 to 2003, 4967 men were diagnosed with histologically confirmed invasive penile SCC in the United States, representing less than 1% of new cancers in men. The annual, average age-adjusted incidence rate was 0.81 cases per 100,000 men, and rates increased steadily with age. Overall, penile SCC incidence was comparable in whites and blacks, but approximately 2-fold lower in Asians/Pacific Islanders. Rates among Hispanics were 72% higher compared with non-Hispanics. Blacks compared with whites and Asians/Pacific Islanders and Hispanics compared with non-Hispanics were diagnosed at significantly younger ages. Higher rates of mortality were also observed among blacks compared with whites and Hispanics compared with non-Hispanics. Penile SCC incidence and mortality were elevated in Southern states and in regions of low socioeconomic status (SES). Some histologic and anatomic site differences were observed by race and ethnicity. Treatment of penile SCC varied with age, stage, and other tumor characteristics. CONCLUSIONS There are considerable disparities in invasive penile cancer incidence and mortality in the United States. Key risk factors for excess incidence include Hispanic ethnicity and residence in the South and in low SES regions. Risks for excess mortality include these factors in addition to black race. Decreases in penile cancer incidence and mortality in the United States may be realized in the future as the indirect result of prophylactic HPV vaccination of females. Further research is needed to better understand the epidemiology of penile cancer including the role of HPV.

Epidemiological study of penile cancer in Pernambuco: experience of two reference centers

“…These results are similar to a Brazilian epidemiological study of PC (6), in a study performed in the state of Pará (8) and in the Kenyan study (21). And different from the North American study (10), where 62.4% of patients were diagnosed in the initial and localized phases. The bigger the lesion and the more invasive, the higher is the possibility of lymph node involvement and worse prognosis (23).…”

Update on Human Papillomavirus (HPV) Vaccines

“…Aside from HPV infection, risk factors associated with penile cancer include smoking, lack of circumcision, phimosis, chronic penile inflammation and immunosuppression. (47,48) There is also wide variation in incidence observed internationally and between ethnic groups which may be related in part to circumcision status. (38,48) Circumcision is associated with a three-fold reduction in risk of penile cancer.…”

“…(47,48) There is also wide variation in incidence observed internationally and between ethnic groups which may be related in part to circumcision status. (38,48) Circumcision is associated with a three-fold reduction in risk of penile cancer. (49,50) Similar to anal cancer, Louchini et al find that in Quebec, survival probability following penile cancer diagnosis has decreased from 75% in 1984 to 59% in 1995.…”

Human Papilloma Virus (HPV) and Genital Cancer

“…If the affectation is in the gland, we may use laser therapy, micrographic Mohs surgery or directly perform a glandectomy. We may also fall back on the use of combined techniques [13,43,44].…”

“…The International Agency for Cancer Research (IACR), which belongs to the WHO, classifies HPV types 16 and 18 as carcinogenic and types 31 and 33 as probably carcinogenic [1]. More recently, based on data from 11 studies carried out in various countries, in which the relationship between the cervix and HPV have been studied, 15 high-risk oncological viral strains have been identified (HR-HPV) (16,18,31,33,35,39,45, 51, 52,56, 58, 59, 68, 73 y 82); strains 26, 53 and 66 have been classified as possible high-risk, and strains 6,11,40,42,43,44,54,61,70,72, 81 and CP6108 have been classified as low-risk (LR-HPV) [2].…”