Risk factors of Penile Cancer

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The risk factors for penile cancer include many things such as sexual activity, smoking, poor hygiene and low socioeconomic status.


The major penile cancer risk factors include human papillomavirus (HPV) infection and phimosis​1​. Other risk factors include sexual activity, smoking, poor hygiene and low socioeconomic status. One can significantly order these risk factors and the incidence of penile cancer has decreased in risk-adjusted populations.


Phimosis, associated with poor hygiene, smegma accumulation, chronic inflammation, increases the risk of developing penile cancer. In fact, it associates with 90% of cancers​2​. Religious practices influence the incidence of penile cancer because the disease is rare even in high-risk groups of circumcised Jewish men and newborns in India and Nigeria, where infant circumcision is practised. In the United States, 79% of men are circumcised, and the incidence of penile cancer is also low​3​. The incidence of penile cancer is reduced with neonatal circumcision. However, whether adult circumcision has the same protective effect is controversial. Circumcision decreases the risk of infection with HPV oncogenic serotypes and also other sexually transmitted infections (STIs). Despite the clear benefits of daily circumcision, the defence of routine circumcision is still controversial, as opponents emphasize the protective effect of foreskin.

HPV infection

The prevalence of HPV in penile cancer is 42–48%. In fact, HPV infection resulted in 63% of penile cancer cases in the high-risk region of Maranhão, Brazil​1​. Sexual transmission increases the risk of HPV infection, anogenital warts, and also concomitant STIs. There are oncogenic HPV serotypes 16 and 18 associated with penile cancer. Carcinogenesis is thought to be due to oncogene products E6 and E7, which bind to tumor suppressor genes and alter cell cycle activity.

Other risk factors

Several studies show that, cigarette smoking altogether increases the risk of penile cancer. However, many studies showed no association. Several studies have lined penile trauma, lichen sclerosus, and also UV-A photochemistry to penile cancer.


  1. 1.
    Christodoulidou M, Sahdev V, Houssein S, Muneer A. Epidemiology of penile cancer. Curr Probl Cancer. 2015;39(3):126-136. doi:10.1016/j.currproblcancer.2015.03.010
  2. 2.
    Daling J, Madeleine M, Johnson L, et al. Penile cancer: importance of circumcision, human papillomavirus and smoking in in situ and invasive disease. Int J Cancer. 2005;116(4):606-616. doi:10.1002/ijc.21009
  3. 3.
    Xu F, Markowitz L, Sternberg M, Aral S. Prevalence of circumcision and herpes simplex virus type 2 infection in men in the United States: the National Health and Nutrition Examination Survey (NHANES), 1999-2004. Sex Transm Dis. 2007;34(7):479-484. doi:10.1097/01.olq.0000253335.41841.04