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Long-term trends in incidence, survival and mortality of primary penile cancer in England



Few population-based studies exist of long-term trends in penile cancer. We report incidence and mortality trends in England over the 31 years 1979–2009 and survival trends over the 40 years 1971–2010.


We calculated annual incidence and mortality rates per 100,000 by age and calendar period. We estimated incidence and mortality rate ratios for cohorts born since 1890, and one- and five-year relative survival (%) by age and deprivation category.


A total of 9,690 men were diagnosed with penile cancer during 1979–2009. Age-standardized incidence rates increased by 21 %, from 1.10 to 1.33 per 100,000. Mortality rates fell by 20 % after 1994, from 0.39 to 0.31 per 100,000. Survival analyses included 11,478 men diagnosed during 1971–2010. Five-year relative survival increased from 61.4 to 70.2 %. Five-year survival for men diagnosed 2006–2010 was 77 % for men aged under 60 years and 53 % for men aged 80–99 years. The 8 % difference in five-year survival (66–74 %) between men in the most affluent and most deprived groups was not statistically significant.


The 21 % increase in penile cancer incidence in England since the 1970s may be explained by changes in sexual practice, greater exposure to sexually transmitted oncogenic human papilloma viruses, and decreasing rates of childhood circumcision. Improvement in survival is likely due to advances in diagnostic, staging and surgical techniques. There is a need for public health education and potential preventative strategies to address the increasing incidence.

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  1. Office for National Statistics (2012) Mortality Metadata. 2012 Nov

  2. Office for National Statistics (2010) Cancer Statistics Registrations, England.

  3. World Health Organisation (1994) International statistical classification of diseases and related health problems. Tenth revision. WHO, Geneva

    Google Scholar 

  4. Office for National Statistics (2011) Population Estimates for UK, England and Wales, Scotland and Northern Ireland–Population Estimates Timeseries 1971 to Current Year

  5. Waterhouse JAH, Muir CS, Correa P, Powell J (1976) Cancer incidence in five continents, vol 3. IARC Scientific Publications, Lyon

    Google Scholar 

  6. Jensen OM, Parkin DM, MacLennan R, Muir CS, Skeet RG (eds) (1991) Cancer registration: principles and methods (IARC Scientific Publications No. 95). International Agency for Research on Cancer, Lyon

    Google Scholar 

  7. Rachet B, Woods LM, Mitry E, Riga M, Cooper C, Quinn MJ, Steward JA, Brenner H, Estève J, Sullivan R, Coleman MP (2008) Cancer survival in England and Wales at the end of the 20th century. Br J Cancer 99(Suppl. 1):2–10

    Article  Google Scholar 

  8. Brenner H, Rachet B (2004) Hybrid analysis for up-to-date long-term survival rates in cancer registries with delayed recording of incident cases. Eur J Cancer 40:2494–2501

    PubMed  Article  Google Scholar 

  9. Corazziari I, Quinn MJ, Capocaccia R (2004) Standard cancer patient population for age standardising survival ratios. Eur J Cancer 40:2307–2316

    PubMed  Article  Google Scholar 

  10. Department of the Environment Transport and the Regions (2000) Measuring multiple deprivation at the small area level: the indices of deprivation 2000. DETR, London

    Google Scholar 

  11. Cancer Research UK Cancer Survival Group (2010) Strel computer program version 5.8 for cancer survival analysis. London School of Hygiene and Tropical Medicine [cited 2011 Jul 28] Available from

  12. Graafland NM, Verhoeven RH, Coebergh JW, Horenblas S (2011) Incidence trends and survival of penile squamous cell carcinoma in the Netherlands. Int J Cancer 128:426–432

    PubMed  Article  CAS  Google Scholar 

  13. Barnholtz-Sloan JS, Maldonado JL, Pow-sang J, Giuliano AR (2007) Incidence trends in primary malignant penile cancer. Urol Oncol 25:361–367

    PubMed  Article  Google Scholar 

  14. Goodman MT, Hernandez BY, Shvetsov YB (2007) Demographic and pathologic differences in the incidence of invasive penile cancer in the United States, 1995–2003. Cancer Epidemiol Biomarkers Prev 16:1833–1839

    PubMed  Article  Google Scholar 

  15. Pukkala E, Weiderpass E (2002 Dec) Socio-economic differences in incidence rates of cancers of the male genital organs in Finland, 1971–95. Int J Cancer 20(102):643–648

    Article  Google Scholar 

  16. Frisch M, Friis S, Kjaer SK, Melbye M (1995) Falling incidence of penis cancer in an uncircumcised population (Denmark 1943–90). BMJ 311:1471

    PubMed  Article  CAS  Google Scholar 

  17. Dillner J, von Krogh G, Horenblas S, Meijer CJ (2000) Etiology of squamous cell carcinoma of the penis. Scand J Urol Nephrol Suppl 205:189–193

    PubMed  Article  Google Scholar 

  18. Health Protection Agency. Health Protection Report. 2011. Apr 28. Vol 5. No.17

  19. Arya M, Kalsi J, Kelly J, Muneer A (2013) Malignant and premalignant lesions of the penis. BMJ 346:f1149

    PubMed  Article  Google Scholar 

  20. Robinson D, Coupland V, Moller H (2009) An analysis of temporal and generational trends in the incidence of anal and other HPV-related cancers in Southeast England. Br J Cancer 100:527–531

    PubMed  Article  CAS  Google Scholar 

  21. Poblet E, Alfaro L, Fernander-Segoviano P, Jimenez-Reyes J, Salido EC (1999) Human papillomavirus-associated penile squamous cell carcinoma in HIV-positive patients. Am J Surg Pathol 23:1119–1123

    PubMed  Article  CAS  Google Scholar 

  22. Castellsague X, Bosch FX, Munoz N et al (2002) Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med 346:1105–1112

    PubMed  Article  Google Scholar 

  23. Rickwood AM, Kenny SE, Donnell SC (2000) Towards evidence based circumcision of English boys: survey of trends in practice. BMJ 321:792–793

    PubMed  Article  CAS  Google Scholar 

  24. Swerdlow AJ, Dos Santos Silva I, Doll R (2001) Cancer incidence and mortality in England and Wales: trends and risk factors. Oxford University Press, Oxford

    Book  Google Scholar 

  25. Office for National Statistics (2012). General Lifestyle Survey Overview

  26. Castellsague X, Munoz N (2003) Chapter 3: cofactors in human papillomavirus carcinogenesis–role of parity, oral contraceptives, and tobacco smoking. J Natl Cancer Inst Monogr 31:20–28

    PubMed  Article  Google Scholar 

  27. Kroon BK, Horenblas S, Meinhardt W et al (2005) Dynamic sentinel node biopsy in penile carcinoma: evaluation of 10 years experience. Eur Urol 47:601–606

    PubMed  Article  Google Scholar 

  28. Hadway P, Smith Y, Corbishley C, Heenan S, Watkin NA (2007) Evaluation of dynamic lymphoscintigraphy and sentinel lymph-node biopsy for detecting occult metastases in patients with penile squamous cell carcinoma. BJU Int 100:561–565

    PubMed  Article  Google Scholar 

  29. Verhoeven RH, Janssen-Heijnen ML, Saum KU et al (2013) Population-based survival of penile cancer patients in Europe and the United States of America: no improvement since 1990. Eur J Cancer 49:1414–1421

    PubMed  Article  CAS  Google Scholar 

  30. Pietrzak P, Corbishley C, Watkin N (2004) Organ-sparing surgery for invasive penile cancer: early follow-up data. BJU Int 94:1253–1257

    PubMed  Article  Google Scholar 

  31. Hernandez BY, Barnholtz-Sloan J, German RR et al (2008) Burden of invasive squamous cell carcinoma of the penis in the United States, 1998-2003. Cancer 113(10 Suppl):2883–2891

    PubMed  Article  Google Scholar 

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Manit Arya acknowledges Orchid Charity and The Barts and London Charity.

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Correspondence to Manit Arya.

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Arya, M., Li, R., Pegler, K. et al. Long-term trends in incidence, survival and mortality of primary penile cancer in England. Cancer Causes Control 24, 2169–2176 (2013).

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  • Penile cancer
  • Incidence
  • Mortality
  • Survival
  • Epidemiology