Penile cancer risk factors

Prevention

Preventable cases of penile cancer, UK

HPV

Penile cancer cases linked to human papillomavirus (HPV) infection, UK

40% of penile cancer cases each year in the UK are linked to major lifestyle and other risk factors.[1]

Penile cancer risk is associated with a number of risk factors.[2,3]

Penile Cancer Risk Factors

  Increases risk Decreases risk
'Sufficient' or 'convincing' evidence
  • Human papillomavirus (HPV) type 16
 
'Limited' or 'Probable' evidence
  • Human immunodeficiency virus (HIV) type 1
  • HPV type 18
 
International Agency for Research on Cancer (IARC) classification. World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classification does not include penile cancer because it is not generally recognised to have a relationship to food, nutrition, and physical activity.

References

  1. Parkin DM. Cancers attributable to infection in the UK in 2010. Br J Cancer 2011;105(S2):S49-S56.
  2. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 117*. Accessed January 2017.
  3. World Cancer Research Fund International/American Institute for Cancer Research. Continuous Update Project Findings & Reports. Accessed January 2017.
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Human papillomavirus (HPV) Open a glossary item type 16 is classified by the International Agency for Research on Cancer (IARC) as a cause of penile cancer, and HPV type 18 is classified as a probable cause of penile cancer, based on limited evidence.[1] An estimated 40% of penile cancers in the UK are linked to HPV.[2]

Around 45-63% of penile squamous cell Open a glossary item carcinomas are HPV-positive, systematic reviews and registry studies have shown; there is some evidence of variation between world regions.[3,4,5] HPV type 16 is the most common type in penile squamous cell carcinomas, followed by HPV types 18 and 6.[3,4,5]

References

  1. International Agency for Research on Cancer. List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 117*. Accessed January 2017.
  2. Parkin DM. Cancers attributable to infection in the UK in 2010. Br J Cancer 2011;105(S2):S49-S56.
  3. Backes DM, Kurman RJ, Pimenta JM, et al. Systematic review of human papillomavirus prevalence in invasive penile cancer. Cancer Causes Control. 2009 May;20(4):449-57.
  4. Miralles-Guri C, Bruni L, Cubilla AL, et al. Human papillomavirus prevalence and type distribution in penile carcinoma. J Clin Pathol. 2009 Oct;62(10):870-8.
  5. Saraiya M, Unger ER, Thompson TD, et al. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. J Natl Cancer Inst. 2015 Apr 29;107(6):djv086.
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Human immunodeficiency virus (HIV) Open a glossary item type 1 is classified by the International Agency for Research on Cancer (IARC) as a probable cause of penile cancer, based on limited evidence.[1]

Penile cancer risk is around 4 times as high in people with HIV/AIDS compared with the general population, a meta-analysis Open a glossary item showed.[2] This may reflect higher rates of human papillomavirus (HPV) infection in men with HIV.[3]

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Penile cancer risk is more than 4 times as high in current smokers, compared with never smokers, a population-based case-control study showed.[1] The association is probably independent of other risk factors including human papillomavirus (HPV) infection, and may reflect an immunosuppressive effect of smoking.[1]

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Penile cancer risk among men who were not circumcised in childhood is at least 5 times as high in those with a history of phimosis (inability to retract the foreskin over the glans), compared with those without a history of phimosis, case-control studies have shown.[1-4]

Invasive penile carcinoma risk is 67% lower in men circumcised as a child or adolescent, a meta-analysis showed; this is probably partly due to circumcision reducing the risk of phimosis.[5]

References

  1. Madsen BS, van den Brule AJ, Jensen HL, et al. Risk factors for squamous cell carcinoma of the penis--population-based case-control study in Denmark. Cancer Epidemiol Biomarkers Prev. 2008 Oct;17(10):2683-91.
  2. Tsen HF, Morgenstern H, Mack T, et al. Risk factors for penile cancer: results of a population-based case-control study in Los Angeles County (United States). Cancer Causes Control. 2001 Apr;12(3):267-77.
  3. Brinton LA, Li JY, Rong SD, Huang S, et al. Risk factors for penile cancer: results from a case-control study in China. Int J Cancer. 1991 Feb 20;47(4):504-9.
  4. Daling JR, Madeleine MM, Johnson LG, et al. Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease. Int J Cancer. 2005 Sep 10;116(4):606-16.
  5. Larke NL, Thomas SL, dos Santos Silva I, et al. Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control. 2011 Aug;22(8):1097-110. doi: 10.1007/s10552-011-9785-9.
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