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Risks and causes

Read about what causes penile cancer, including lifestyle factors and other medical conditions, and see what you can do to reduce your risk.

The exact cause of penile cancer is not known but there are several risk factors. 

Having any of these risk factors doesn’t mean that you will definitely develop cancer.

HPV is a common infection that gets passed from one person to another by sexual contact.

Around 8 out of 10 people (80%) in the UK get infected with the HPV virus at some time during their lifetime. For most people the virus causes no harm and goes away without treatment. But men with human papilloma virus have an increased risk of developing cancer of the penis. 

Some research studies have tried to find the link between penile cancer and HPV. Around 5 out of 10 (50%) men with penile cancer have evidence of HPV infection. HPV also increases the risk of cervical, anal, vulval and vaginal cancers. Some types cause genital warts.

There are over 100 types of HPV and each one has a number. The main types of HPV found in men with penile cancer are HPV 16 and 18. There may be other types too. HPV 16 and 18 don't usually cause genital warts. There is evidence that men with a history of genital warts have an increased risk of penile cancer.

In a Danish study, men who had never used condoms had more than double the risk of penile cancer. They were compared to men who had used condoms. This may be because condoms reduce the risk of HPV infection. Men who have two or more sexual partners before the age of 20 have a 4 to 5 times increased risk of penile cancer. This may also be due to HPV infection.

Circumcision seems to reduce the risk of HPV infection of the penis.

Penile cancer is more common in men aged 50 or over. It is rare in men under the age of 40.

Men who smoke may be more likely to develop penile cancer. Researchers believe the chemicals in cigarettes may damage the DNA of cells in the penis and increase the risk of developing cancer.

Cells in the lining of the penis, called Langerhans cells, help fight disease. These cells don't work so well in smokers and can’t fight off viruses as well as they do in non-smokers. So if you smoke and have a high risk type of HPV infection, you may be more at risk of penile cancer.

The immune system fights infection and diseases like cancer in the body. You may be at higher risk of penile cancer if you have a weakened immune system, and other cancers.  

HIV infection or AIDS may lower the immune system. Some drugs after an organ transplant may also weaken the immune system.

Circumcision is a small operation to remove part, or all, of the foreskin. Uncircumcised men may sometimes find it difficult to draw back their foreskin. This is called phimosis. Men with phimosis have a higher risk of penile cancer than other men. 

The reason for this is not clear. It may relate to other known risk factors, including a build-up of secretions under the foreskin. Smegma is a cheese-like substance made up of dead skin cells that can build up under a tight foreskin. This can cause irritation and inflammation of the penis if it is not cleaned on a regular basis.

Male babies may have a circumcision at birth for social or religious reasons. The age of circumcision can affect the risk of penile cancer:

  • men who are circumcised as babies appear to be less likely to get penile cancer.
  • men who are circumcised in their teens seem to have some protection from penile cancer.
  • circumcision in adulthood seems to make no difference to a man’s risk of penile cancer.

Remember that not being circumcised is only one risk factor for this type of cancer. Other risk factors such as smoking and HPV infection are more important.

Psoriasis (pronounced sore-eye-ah-sis) is a chronic skin condition. You can't catch it from another person. It is sometimes treated with a combination of a drug called psoralen and light therapy (phototherapy). This treatment is called PUVA and can also be a cancer treatment. Men who have had PUVA appear to have an increased risk of penile cancer.

Other possible causes

Stories about potential causes are often in the media and it isn’t always clear which ideas are supported by evidence. There might be things you have heard of that we haven’t included here. This is because either there is no evidence about them or it is less clear.

Last reviewed: 
10 Mar 2016
  • Burden of Invasive Squamous Cell Carcinoma of the Penis in the United States, 1998–2003

    B Hernandez and others

    Cancer. 2008 November 15; 113(10 Suppl): 2883–2891.

     

    Human papillomavirus prevalence and type distribution in penile carcinoma

    C Miralles-Guri and others

    Journal of Clinical Pathology. 2009 Oct;62(10):870-8

     

    Cancer risk among patients with condylomata acuminata

    C Nordenvall and others

    International Journal of Cancer. 2006 Aug 15;119(4):888-93

     

    Associations between male anogenital human papillomavirus infection and circumcision by anatomic site sampled and lifetime number of female sex partners

    C Nielson and others

    Journal of Infectious Disease. 2009 Jan 1;199(1):7-13

     

    Circumcision and human papillomavirus infection in men: a site-specific comparison

    B Hernandez and others

    Journal of Infectious Disease. 2008 Mar 15;197(6):787-94

     

    Familial clustering of cancer at human papillomavirus-associated sites according to the Swedish Family-Cancer Database

    S Hussain and others

    International Journal of Cancer. 2008 Apr 15;122(8):1873-8

     

    Risk factors for squamous cell carcinoma of the penis -- population-based case-control study in Denmark

    B Madsen and others

    Cancer Epidemiology Biomarkers and Prevention. 2008 Oct;17(10):2683-91

     

    The immune system and cancer

    Loose D1, Van de Wiele C.

    Cancer Biotherapy and Radiopharmaceuticals. 2009 Jun;24(3):369-76

     

    Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease

    Daling JR1, Madeleine MM, Johnson LG, Schwartz SM, Shera KA, Wurscher MA, Carter JJ, Porter PL, Galloway DA, McDougall JK, Krieger JN.

    International Journal of Cancer. 2005 Sep 10;116(4):606-16

     

    Principles and practice of oncology (8th edition)

    VT De Vita, S Hellman and SA Rosenberg

    Lippincott, Williams and Wilkins, 2008

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