Penile Cancer Epidemiology and Risk Factors

A Contemporary Review

Antoin Douglawi; Timothy A. Masterson


Curr Opin Urol. 2019;29(2):145-149. 

In This Article

Premalignant Lesions

Premalignant lesions are benign precursors with a potential for progression to penile SqCC. The risk of malignant transformation is unclear, but some authors have reported rates as high as 30% after a significant lag time,[23] which presents an opportunity for early intervention. These lesions can be divided into HPV and non-HPV--related entities.[24] hrHPV strains 16 and 18 are associated with Bowen's disease, Bowenoid papillosis, erythroplasia of Queyrat. Conversely, low-risk HPV strains 6 and 11 are associated with condyloma acuminata and Buschke-Lowenstein tumors.[25] Non-HPV--related lesions consist of inflammatory conditions such as lichen sclerosus, leukoplakia, penile cutaneous horn, and some forms of balanitis.[26] These conditions are related to chronic inflammation that can be perpetuated by the warm and moist subpreputial environment.[27] As an illustrative example, lack of circumcision was noted in 98% of patients with lichen sclerosus[28] and balanitis prevalence was 68% lower in circumcised versus uncircumcised males [odds ratio (OR) 0.32].[29] These findings support early intervention with circumcision in at risk populations.