Epidemiology of Penile Cancer

Penile cancer is a rare disease that constitutes 0.2 % of all male malignancies in Western countries but can account for over 10 % of malignant disease in men in some parts of Africa, Asia and South-America. This variation is mostly explained by socio-economic conditions and religious practices. Circumcision is found to be a protective factor (OR 0.33), mainly by prevention of phimosis. Penile cancer is also directly associated with areas of poverty. Oncogenic subtypes of the human papilloma virus (HPV) have been strongly associated with penile cancer and are found in 20–50 % of tumors. Furthermore, genital lichen sclerosus (LS) in men is a chronic inflammatory condition which can result in the development of a phimosis. LS is associated with up to 30 % of penile cancers. Other factors associated with an increased risk of penile cancer are tobacco use (RR 2.8), Psoralen-UV-A photochemotherapy, penile injury, genital warts and HIV infection.