The causes and the way that penile cancer develops is not fully understood but there are some factors which increase the risk.
Human Papilloma Virus (HPV)
There are many different types of HPV virus. Common types can cause warts and verruca’s spread by skin-to-skin contact. Some types of HPV are transmitted via sexual intercourse, and several are considered high risk viruses. These can infect the anus, penis, throat, and cervix in women, and are linked with the development of cancer. The body’s immune system is usually able to kill the virus, but sometimes it can persist for many years without causing any symptoms and then develop into cancer or a pre-cancerous condition. Around 50% of men diagnosed with the most common type of penile cancer have been infected with one of these types of HPV.
It has been estimated that over 80% of the world’s population are exposed to HPV during their lifetime. Getting penile cancer does not mean that an individual’s lifestyle is to blame. Practicing safe sex using a condom can help reduce the risk of HPV as well as Sexually Transmitted Infections (STIs).
Many young women around the world receive a vaccine to prevent HPV infection which is linked to cervical cancer. Recently, some countries have begun to offer this vaccination to boys, to reduce the risk of HPV related cancer. It may also be given to men following a diagnosis of penile cancer if the cancer is linked to HPV infection.
The Presence of the Foreskin
Penile cancer is rare in men who have been circumcised (surgical removal of the foreskin) as a baby. Circumcision in later life does not reduce the risk of penile cancer and the risk of for these men is greater in the presence of phimosis (below).
This is the inability to pull back or retract the foreskin fully. It can be a result of skin irritation or inflammation or affect some men from birth. It will reduce the ability of a man to clean the penis thoroughly or notice any abnormal changes. It may also increase the risk of HPV infection. Research suggests that men with phimosis are around 10 times more at risk of developing penile cancer.
Some research has suggested that smoking may increase the chance of developing penile cancer. This may be due to harmful chemicals found in cigarettes which are passed out in urine and may react with substances that can build up under the foreskin causing abnormal changes in the penis.
Psoralen-UV-A Photochemotherapy (PUVA)
Psoralen-UV-A Photochemotherapy (PUVA) is used to treat some forms of skin disease such as psoriasis, as well as some types of cancer. High doses of PUVA can increase the risk of penile cancer.
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Reviewed November 2023