National Trends and Predictors of Locally Advanced Penile Cancer in the United States (1998-2012)

Juan Chipollini; Sharon Chaing; Charles C Peyton; Pranav Sharma; Laura C Kidd; Anna R Giuliano; Peter A Johnstone; Philippe E Spiess

doi:10.1016/j.clgc.2017.07.031

National Trends and Predictors of Locally Advanced Penile Cancer in the United States (1998-2012)

Clin Genitourin Cancer. 2017 Aug 12:S1558-7673(17)30241-0. doi: 10.1016/j.clgc.2017.07.031. Online ahead of print.

Authors

Juan Chipollini¹, Sharon Chaing², Charles C Peyton³, Pranav Sharma⁴, Laura C Kidd², Anna R Giuliano⁵, Peter A Johnstone⁶, Philippe E Spiess³

Affiliations

¹ Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL. Electronic address: juan.chipollini@moffitt.org.
² Morsani College of Medicine, University of South Florida, Tampa, FL.
³ Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL.
⁴ Department of Urology, Texas Tech University Health Science Center, Lubbock, TX.
⁵ Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL.
⁶ Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL.

PMID: 28866244
DOI: 10.1016/j.clgc.2017.07.031

Abstract

Background: We analyzed the trends in presentation of squamous cell carcinoma (SCC) of the penis and determined the socioeconomic predictors for locally advanced (cT3-cT4) disease in the United States.

Patient and methods: The National Cancer Database was queried for patients with clinically nonmetastatic penile SCC and staging available from 1998 to 2012. Temporal trends per tumor stage were evaluated, and a multivariable logistic regression model was used to identify predictors for advanced presentation during the study period.

Results: A total of 5767 patients with stage ≤ T1-T2 (n = 5423) and T3-T4 (n = 344) disease were identified. Increasing trends were noted in all stages of penile SCC with a greater proportion of advanced cases over time (P = .001). Significant predictors of advanced presentation were age > 55 years, the presence of comorbidities, and Medicaid or no insurance (P < .05 for all).

Conclusion: More penile SCC is being detected in the United States. Our results have demonstrated older age, presence of comorbidities, and Medicaid or no insurance as potential barriers to early access of care in the male population. Understanding the current socioeconomic gaps could help guide targeted interventions in vulnerable populations.

Keywords: Advanced stage; Age; Comorbidity; Diagnosis; Human papilloma virus; Insurance; Squamous cell carcinoma of the penis.