Editing EAU & ASCO: Penile Cancer 2023 (section)

== Pathophysiology ==

=== Risk factors (8) ===

# '''<span style="color:#ff0000">Human papilloma virus (HPV)'''
#* '''<span style="color:#ff0000">Most important risk factor'''
#* '''Most frequent HPV genotypes: HPV16 followed by HPV6'''
#* Risk of penile cancer is increased in patients with condyloma acuminata
#* Female sexual partners of patients with penile cancer have not been found to have an increased incidence of cervical cancer
#* HPV vaccination
#** No general recommendation (except in a few countries) for HPV vaccination in males because of the different HPV-associated risk patterns in penile- and cervical cancer
#** Since up to 50% of invasive penile carcinomas and 80% of preneoplastic lesions are HPV-associated, HPV vaccination is encouraged
# '''<span style="color:#ff0000">Phimosis'''
#* Strongly associated with invasive penile cancer due to associated chronic infections
#* Smegma is not a carcinogen
#* '''Neonatal circumcision reduces the incidence of penile cancer, but does not reduce the risk of Penile Intraepithelial Neoplasia (PeIN)'''
# '''<span style="color:#ff0000">Chronic penile inflammation'''
# '''<span style="color:#ff0000">Lichen sclerosus'''
# '''<span style="color:#ff0000">Ultraviolet A phototherapy'''
# '''<span style="color:#ff0000">Cigarette smoking'''
# '''<span style="color:#ff0000">Low level of education'''
# '''<span style="color:#ff0000">Low socio-economic status'''