Risks and causes of penile cancer
This page tells you about the risks and causes of penile cancer. We don’t know exactly what causes penile cancer. But there are some known risk factors. There is information below about
Risks and causes of penile cancer
Penile cancer is a rare cancer in Western countries including the UK. We don’t know exactly what causes penile cancer. But there are some known risk factors.
Main risk factors
As with many cancers, it is more common in older people - most cases are in men over 60. You may have an increased risk if your father had penile cancer, but as it is such a rare condition, this is still a very small risk.
The human papilloma virus (HPV) increases penile cancer risk. Around 5 out of 10 men with penile cancer have HPV infection.
Other risk factors
Other risk factors include smoking and having a weakened immune system. Factors that lower risk include being circumcised and taking care over personal hygiene.
You can view and print the quick guides for all the pages in the about penile cancer section.
Penile cancer is a rare cancer in Western countries. Around 520 men are diagnosed each year in the UK. That means that only 3 out of every 1,000 cancers diagnosed in men in the UK are penile cancer. It is more common in men who live in Asia, Africa or South America.
HPV is a common infection and is passed from one person to another by sexual contact. Around 8 out of 10 people (80%) in the UK will be 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. A number of research studies have tried to establish the link between penile cancer and HPV. These studies show that the number of men with penile cancer who have evidence of HPV infection is around 5 out of 10 (47%). HPV also increases the risk of cervical, anal, vulval and vaginal cancers.
HPV is commonly called the ‘wart virus’ because 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, although other types may also be related too. HPV 16 and 18 do not usually cause genital warts but 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 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 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.
It is rare for men below the age of 40 to get penile cancer. Most cases are in men aged over 60.
Men who smoke may be more likely to develop cancer of the penis. There are chemicals that cause cancer (benzyrene) in cigarettes. Researchers believe that these 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 do not 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.
If you have a weakened immune system, you have an increased risk of penile cancer (and other cancers). Your immune system may be weakened if you have HIV or AIDS, or because you need to take drugs to damp down your immune system after having an organ transplant.
Circumcision is a small operation to remove part, or all, of the foreskin. Male babies may be circumcised at birth for hygiene or religious reasons. The age you are circumcised appears to affect the risk of penile cancer.
- Men who are circumcised as babies appear to be less likely to develop 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
However, it is important to remember that circumcision is only one risk factor for this type of cancer. Other risk factors such as smoking and HPV infection are more important.
Uncircumcised men should regularly pull back their foreskin to clean under it. If they don’t do this, secretions and dead skin cells can build up. This thick, often bad smelling substance (known as smegma) can cause irritation and inflammation of the penis. Men who have difficulty drawing back their foreskin (a condition called phimosis) may get a build up of smegma. Men with phimosis have a risk of penile cancer that is 5 to 11 times higher than other men. But because penile cancer is rare their risk is still small.
Men who have had a painful erection lasting several hours (known as priapism) have a risk of penile cancer that is 9 times that of other men. Priapism is a persistent, usually painful, erection that lasts for more than 4 hours and occurs without sexual stimulation. It develops when blood in the penis becomes trapped and unable to drain. It sometimes happens without a known cause but can be due to
- Illnesses such as sickle-cell disease, leukaemia or malaria
- An injury to the penis or the area between the scrotum and anus
- Some medicines, and cocaine or marijuana (cannabis) use
Although 9 times the risk sounds a lot, because penile cancer is a relatively rare disease, 9 times that risk is still a small risk.
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 known as PUVA and can also be a cancer treatment. Men who have had PUVA appear to have an increased risk of penile cancer.
Sons or brothers of men with penile squamous cell cancer (SCC) have about 8 times the risk of penile SCC compared to men without a family history. Sons of men with rectal cancer have double the risk. But their risk is still small.
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