Risk Factors for Squamous Cell Carcinoma of the Penis—Population-Based Case-Control Study in Denmark

Abstract

Few etiologic studies of squamous cell carcinoma (SCC) of the penis have been carried out in populations where childhood circumcision is rare. A total of 71 patients with invasive (n = 53) or in situ (n = 18) penile SCC, 86 prostate cancer controls, and 103 population controls were interviewed in a population-based casecontrol study in Denmark. For 37 penile SCC patients, tissue samples were PCR examined for human papillomavirus (HPV) DNA. Overall, 65% of PCR-examined penile SCCs were high-risk HPV-positive, most of which (22 of 24; 92%) were due to HPV16. Penile SCC risk was positively associated with measures of early and high sexual activity, including lifetime number of female sex partners, number of female sex partners before age 20, age at first intercourse, penile-oral sex, a history of anogenital warts, and never having used condoms. Histories of phimosis and priapism at least 5 years before diagnosis were also significant risk factors, whereas alcohol abstinence was associated with reduced risk. Our study confirms sexually transmitted HPV16 infection and phimosis as major risk factors for penile SCC and suggests that penileoral sex may be an important means of viral transmission. The association with priapism was unexpected and needs replication. (Cancer Epidemiol Biomarkers Prev 2008;17(10):2683 -91)

Comprehensive Genomic Profiling of Advanced Penile Carcinoma Suggests a High Frequency of Clinically Relevant Genomic Alterations

“…HPV has been associated with 50%-70% of cases of squamous penile cancer across multiple series, but these studies amalgamate early, and patients with late-stage PSCC who likely have distinct clinicopathologic features and biology [9][10][11][12][13][14]. Broader molecular studies of penile carcinoma have been performed in a limited series of patients, but interpretation is again confounded by heterogeneity of the stage of disease and diagnostic methodologies used [15,16].…”

CUA guideline on the care of the normal foreskin and neonatal circumcision in Canadian infants

“…The protective effect of neonatal circumcision was not statistically significant when the analysis was restricted to those who did not have a history of phimosis (OR 0.79, 95% CI 0.29-2.6) and smoking was a clear identified risk factor (OR 5.9 for > 20 cigarettes/day). In another population based case control study from Denmark, Madsen et al found that penile cancer was positively associated with measures of high and early sexual activity, genital warts, unprotected sex and penile oral sex [136]. Phimosis (OR 4.9, 95% CI 1.85-13.0), but not childhood circumcision (p=0.33) was also found to have a strong association on multivariate analyses.…”

Human Papillomavirus and Related Diseases - From Bench to Bedside - A Clinical Perspective

“…Heidman et al (2007) detecetd HPV DNA in 46 of 83 (55%) and HPV16 was the predominant type, appearing in 24 (52%) of 46 of penile SCCs. In a case control study in Denmark, of the 37 penile SCC patients whose tumor tissues were PCRexamined for the presence of HPV DNA, 24 (65%) were high-risk HPV positive, and 1 (3%) was positive to a low-risk HPV type (HPV 6) [Madsen et al, 2008]. Several studies have confirmed a predominance of penile cancer in the North and Northeast of Brazil which are regions with lower human development indexes (Favorito et al, 2008;Koifman et al, 2011;Reis et al, 2010a).…”