Penile cancer risks can be increased by a number of causes such as smoking, phimosis, poor hygiene, multiple sexual partners and history of gential warts or other sexually transmitted diseases. It has been found that circumcised men have a lower risk of human papillomavirus (HPV) as well as a lower risk of penile cancer. The correlation between penile cancer and HPV has been reported between 30% and 100%, depending on the population and the method of HPV detection. There is no clear connection between high-risk HPV (hrHPV) and the incidence of penile cancer at present. In this study, the authors look at the link between hrHPV and invasive penile cancer in a contemporary Dutch population. Between 2001 and 2009, 487 men were diagnosed with penile cancer; those who received neoadjuvant treatment, those not treated at the centre where the study was carried out, and those with carcinoma in situ were excluded, leaving 212 men eligible for this study. The presence of hrHPV was detected using GP5+6+PCR. Out of 212, 53 (25%) men who were diagnosed with penile cancer were positive for hrHPV, including 43 (79%) containing HPV45, one (2%) HPV31 and one (2%) HPV52. Patients positive for hrHPV were found to have small tumours with 17% well differentiated cells. The positive group patients were found to have better five-year disease specific survival, 96% vs. 83% in hrHPV negative group. There was no link between age and presence of HPV related penile cancer in this study. 

Human papillomavirus prevalence in invasive penile cancer and association with clinical outcome.
Djajdiningrat RS, Jordanova ES, Kroon BK, et al.
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