BACKGROUND: Invasive penile cancer is a rare disease with an approximately 22 000 cases per year. The incidence is higher in less developed countries, where penile cancer can account for up to 10% of cancers among men in some parts of Africa, South America, and Asia. OBJECTIVE: To describe the human papillomavirus (HPV) DNA prevalence, HPV type distribution, and detection of markers of viral activity (ie, E6*I mRNA and p16(INK4a)) in a series of invasive penile cancers and penile high-grade squamous intraepithelial lesions (HGSILs) from 25 countries. A total of 85 penile HGSILs and 1010 penile invasive cancers diagnosed from 1983 to 2011 were included. DESIGN, SETTING, AND PARTICIPANTS: After histopathologic evaluation of formalin-fixed paraffin-embedded samples, HPV DNA detection and genotyping were performed using the SPF-10/DEIA/LiPA25 system, v.1 (Laboratory Biomedical Products, Rijswijk, The Netherlands). HPV DNA-positive cases were additionally tested for oncogene E6*I mRNA and all cases for p16(INK4a) expression, a surrogate marker of oncogenic HPV activity. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: HPV DNA prevalence and type distributions were estimated. RESULTS AND LIMITATIONS: HPV DNA was detected in 33.1% of penile cancers (95% confidence interval [CI], 30.2-36.1) and in 87.1% of HGSILs (95% CI, 78.0-93.4). The warty-basaloid histologic subtype showed the highest HPV DNA prevalence. Among cancers, statistically significant differences in prevalence were observed only by geographic region and not by period or by age at diagnosis. HPV16 was the most frequent HPV type detected in both HPV-positive cancers (68.7%) and HGSILs (79.6%). HPV6 was the second most common type in invasive cancers (3.7%). The p16(INK4a) upregulation and mRNA detection in addition to HPV DNA positivity were observed in 69.3% of HGSILs, and at least one of these HPV activity markers was detected in 85.3% of cases. In penile cancers, these figures were 22.0% and 27.1%, respectively. CONCLUSIONS: About a third to a fourth of penile cancers were related to HPV when considering HPV DNA detection alone or adding an HPV activity marker, respectively. The observed HPV type distribution reinforces the potential benefit of current and new HPV vaccines in the reduction of HPV-related penile neoplastic lesions. PATIENT SUMMARY: About one-third to one-quarter of penile cancers were related to human papillomavirus (HPV). The observed HPV type distribution reinforces the potential benefit of current and new HPV vaccines to prevent HPV-related penile neoplastic lesions.

3rd Faculty of Medicine Charles University and Faculty Hospital King's Vineyards Prague Czech Republic

Cancer Research Center University of Hawaii Honolulu HI USA; Cedars Sinai Medical Center Los Angeles CA USA

Centro de Investigación Epidemiológica en Salud Sexual y Reproductiva CIESAR Hospital General San Juan de Dios Guatemala City Guatemala

Centro de Oncología de Coimbra Coimbra Portugal

CHU Reims Reims France

DDL Diagnostic Laboratory Rijswijk The Netherlands

Eduardo Mondlane University and Maputo Central Hospital Maputo Mozambique

German Cancer Research Center Heidelberg Germany

Hospital de Oncología Centro Médico Nacional Siglo XXI IMSS Mexico D F Mexico

Hospital de Tortosa Verge de la Cinta Tarragona Spain

Hospital del Mar Barcelona Spain

Hospital General Hospitalet Barcelona Spain

Hospital General Universitario de Albacete Albacete Spain

Hospital Oncológico Quito Ecuador

Hospital San Agustín Asturias Spain

Institut Català d'Oncologia Barcelona Spain

Institut Català d'Oncologia Barcelona Spain; CIBER en Epidemiología y Salud Pública Barcelona Spain

Instituto de Investigaciones en Ciencias de la Salud Universidad Nacional de Asunción Asunción Paraguay

Instituto Nacional de Cancerología Bogotá Colombia

Instituto Portugues de Oncologia de Lisboa Francisco Gentil Lisbon Portugal

Instituto Potosino de Investigación Científica y Tecnológica San Luis Potosí Mexico

Jagiellonian University Medical College Krakow Poland

Laboratoire Cerba Saint Ouen l'Aumône France

Medical School of University of Crete Crete Greece

National Cancer Center Goyang si Gyeonggi do South Korea

National Cancer Institute of Colombia Bogota Colombia

Norfolk and Norwich University Hospital NHS Foundation Trust Norfolk UK

The Fingerland Department of Pathology Charles University Prague Faculty of Medicine and University Hospital Hradec Králové Czech Republic

Universidad Autónoma de Honduras Tegucigalpa Honduras

Universidad Central de Venezuela Caracas Venezuela

Universidad de Chile Santiago Chile

University of Philippines Manila Philippines

Westmead Hospital Westmead Australia

Eur Urol. 2016 Dec;70(6):1078-1079. doi: 10.1016/j.eururo.2016.08.035. PubMed

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