Carcinoma of the penis risk factors

Editor(s)-in-Chief: C. Michael Gibson, M.S., M.D. [mailto:mgibson@perfuse.org] Phone:617-632-7753; Joel Gelman, M.D. [mailto:jgelman@uci.edu], Director of the Center for Reconstructive Urology and Associate Clinical Professor in the Department of Urology at the University of   California,Irvine

Risk factors
The American Cancer Society provides the following as risk factors for penile cancer: human papillomavirus (HPV) infection, smoking, smegma, phimosis, treatment of psoriasis, age, and AIDS. The other etiologic factor most commonly associated with penile carcinoma is poor hygiene. There is some evidence that lichen sclerosus (also known as balanitis xerotica obliterans) may also be a risk factor.

Risk
The lifetime risk of a man developing invasive penile cancer (IPC) in the United States is 1 in 600 if he is uncircumcised, and more than 3 times lower if he was circumcised neonatally.

This and other evidence suggests that childhood circumcision reduces the incidence of penile cancer. Studies have found that circumcision decreases the risk of HPV infection in males and thereby the risk of developing penile cancer.

But Wallerstein found that the risk of penile cancer in Finland, Norway, and Denmark (all noncircumcising countries) is about the same (1 in 100,000 per year) as in the US. The American Medical Association and the Royal Australasian College of Physicians say the use of infant circumcision in hope of preventing penile cancer in adulthood is not justified. The American Cancer Society stated in 1998:
 * "... penile cancer risk is low in some uncircumcised populations, and circumcision is strongly associated with other socioethnic practices that are associated with lessened risk. The consensus among studies that have taken these other factors into account is that circumcision alone is not the major factor preventing cancer of the penis. It is important that the issue of circumcision not distract the public's attention from avoiding known penile cancer risk factors -- having unprotected sexual relations with multiple partners (increasing the likelihood of human papillomavirus infection) and cigarette smoking."