Abstract 1929: Incidence and mortality rates of penile cancer among men in Puerto Rico and the United States
Authors: Colon-Lopez Vivian , Ortiz Ana P. , Soto-Salgado Marievelisse , Martinez-Ferrer Magali , Puras Antonio , Suarez Erick 
Published: August 2014

Abstract
Background: Increased insight has been gained into the pathogenesis of penile cancer, since reports indicate that several etiologic factors such as chronic irritation, lack of circumcision, HPV and smoking history are associated to penile malignancies. Higher estimates of penile cancer have been reported among Hispanic men in the US, which correlates with the higher incidence of cervical cancer among Hispanic women as compared with Non-Hispanic whites.
Objectives: To compare the age-adjusted incidence and mortality rates of penile cancer in Puerto Rico (PR) with that of non-Hispanic whites (NHW), non-Hispanic blacks (NHB) and Hispanics in the US.
Methods: Age-standardized rates [ASR (World)] were calculated based on cancer incidence and mortality data from the PR Cancer Central Registry and Surveillance, Epidemiology and End Results (SEER) program SEER, using the direct method and the world population as the standard. Relative Risks (RR) were calculated using the Poisson regression models.
Results: For 2000-2004, the age-standardized incidence rates of penile cancer in these groups ranged form 0.8 per 100,000 in NHW to 2.8 per 100,000 in PR. During this period, men in PR had approximately 4-fold increase incidence of penile cancer as compared to NHW (Standardized rate ratio [SRR]: 3.95, 95% CI = 3.31-4.69). Higher incidence of penile cancer was also observed in PR men as compared to NHB (SRR: 3.45, 95% CI = 2.56-4.80) and Hispanic men (SRR: 2.37, 95% CI = 1.87-3.03). When data was stratified by age-group at penile cancer diagnosis, a significant fold increased incidence (p&lt;0.05) was also observed among men in PR as compared to NHW, NHB and Hispanics, in all age groups (&lt;60, 60-70, 70+ years). Meanwhile for 2000-2004, mortality rates of penile cancer ranged from 0.2 per 100,000 in NHW to 0.6 per 100,000 in PR. Mortality rates from penile cancer were also higher for men in PR as compared to all other ethnic/racial groups in the US. Men in PR had up to 3 fold increased mortality of death than NHW (SRR: 3.43, 95% CI = 2.45-4.59), NHB (SRR: 2.51, 95% CI = 1.73-3.53), and 67% higher risk than Hispanics (SRR: 1.67, 95% CI = 1.16-2.33). Similar results were observed in age-stratified analysis.
Conclusions: Our results support racial and ethnic differences in penile cancer incidence and mortality, with a clear health disparity among men in PR. Although penile cancer is a relatively uncommon tumor, the incidence and mortality rates are significantly higher in PR men as compared with other racial/ethnic groups in the US. Particularly, incidence and mortality rates of penile cancer are significantly higher among PR men &lt;60 years, which differs from previous studies and might suggest the importance of primary prevention efforts among this group. An epidemiological assessment of risk factors is also necessary in order to understand these results and develop clinical and preventive interventions.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1929. doi:10.1158/1538-7445.AM2011-1929