Epidemiologic study on penile cancer in Brazil

Abstract

Objectives: To assess epidemiologic characteristics of penile cancer in Brazil. Materials and Methods: From May 2006 to June 2007, a questionnaire was distributed to all Brazilian urologists. Their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. Results: 283 new cases of penile cancer in Brazil were recorded. The majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. The majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. Of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. A prior medical history positive for HPV infection was reported in 18 of the 283 cases (6.36%). In 101 patients (35.68%) tobacco smoking was reported. The vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. In 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. The majority of the patients (n = 123; 75.26%) presented with T1 or T2; only 9 patients (3.18%) presented with T4 disease. Conclusion: Penile cancer is a very frequent pathology in Brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.

Human Papilloma Virus: Prevalence, distribution and predictive value to lymphatic metastasis in penile carcinoma

“…In Brazil, the incidence varies from 2.9 to 6.8 cases/100.000 inhabitants/ year (2). In an epidemiological study in Pará State, the observed incidence was 5.7 cases/100.000 inhabitants/year (3).…”

Profile of Patients with Penile Neoplasms Who Have Undergone Penectomy

“…About 60% of the cases occur in men ≥ 65 years, however, young individuals may also be affected, as about 22% of the cases are registered in patients ≤ 40 years and 7% in patients ≤ 30 years of age. Comparing data of the world population to those of Brazil, penile cancer occurs earlier in Brazil, since the fourth decade of life [9]. Considering the social class and schooling level, these are generally low, and the areas of highest incidence are located in the poorer regions of developing countries [9,10].…”

“…In regions of higher prevalence, penile tumors even outnumber prostate and bladder neoplasms [9,10]. Studies indicate that the highest rates in the world are observed in Recife, Pernambuco, and Fortaleza, Ceará, Brazil [11].…”

“…Epidemiological analysis of the penile cancer cases indicates that, in relation to the socio-economic-cultural profile of patients with this disease, the neoplasm affects mainly men from a disadvantaged social class and those with a low schooling level, and its areas of highest incidence are located in the poorest regions of developing countries [9,10].…”

Update in the management of penile cancer

“…This rate has been in gradual decline over the last thirty years (1). In developing countries, the incidence is more considerable, due in part to cultural and hygienic differences (2,3). Several etiologic risk factors have been recognized in the development of this malignancy.…”