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  • Author: Mohammed Zaher x
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Scott Cooper, Mohammed Zaher and Gregory Diorio

Objective: Although rare worldwide, primary squamous cell penile cancer (PSPC) is associated with significant psychological stress and cancer-specific mortality. We aim to analyze trends in PSPC in the United States from 2000–2015 using U.S. Surveillance, Epidemiology, and End Results registry (SEER). Clinical identification of risk factors for adverse outcomes will allow for patient-specific counseling on prognosis and intervention. Methods: Population-based data from SEER 18 was used to assess PSPC. SEER Stat was used to calculate incidence, mortality, and survival statistics of PSPC, as well as demographic, geographic, socioeconomic, and clinical variables from 2000 to 2015. Trends were assessed over 5-year spans (2000–2005, 2006–2010, and 2011–2015) using annual percent change. Kaplan-Meier logistic regression analysis was used to calculate 5-year, cancer-specific survival. Results: From 2000–2015, 5,144 men in the U.S. were diagnosed with PSPC at a rate of 0.38 per 100,000, which remained unchanged throughout the entire study period. Asians and Pacific Islanders had the lowest incidence (0.02, 95% CI=0.2, 0.2; P<.05) of all racial groups. Hispanics had a higher incidence (0.58, 95% CI=0.54, 0.62; P<.05) than non-Hispanics. Incidence was highest in the South (0.46, 95% CI=0.43, 0.48; P<.05); however, cancer-specific mortality was similar across regions. No difference in mortality was observed between urban and rural dwelling. Those lacking a high school education and living in areas with more than 10% poverty had a greater incidence of PSPC than others (P<.05). Overall, 5-year cancer-specific survival was 57%, which remained consistent across each studied time interval (P<.05). Compared to previous years, those diagnosed between 2011 and 2015 lacked surgical intervention, were of advanced age (>74–85 years), stage (T1, T2, T3), and with greater lymph node burden (>4) (P<.05). Increased mortality was associated with unmarried men, >20% poverty rate, advanced age, advanced T stage, and lack of surgical treatment (P<.05). Conclusion: Disparity in PSPC continues to exist. Incidence of penile cancer has increased with advanced age and stage. Unmarried, impoverished men with advanced stage and lack of surgical treatment have increased cancer-specific mortality. Efforts should be directed to those most at risk with hopes to identify disease at an earlier stage to provide surgical treatment with curative intent.