33847 The association between penile cancer and HIV infection

Abstract

Penile cancer is rare; in Europe and the USA <1/100,000. As with all nonmelanoma skin cancers, HIV infection appears to increase the risk. The magnitude of this risk and the pathogenesis remain unclear. A review of the literature is currently lacking. A comprehensive review of the literature using Medline, EMBASE and Cochrane Library databases was undertaken using conventional search strategies and coding terms. A total of 24 publications were identified by this methodology, of which nine were case reports and the remaining 15 were observational studies. These studies were highly heterogeneous, with varying study designs, populations, and objectives. The risk of penile cancer within HIV-positive men was 3.7 to 11.1 times that of HIV-negative individuals. HIV was also shown to influence disease characteristics, with a four-fold increased risk of death from penile cancer. Moreover, invasion of in situ carcinoma occurred at a higher rate in HIV, on average 5.9 years sooner than in HIV-negative counterparts. Ethnicity was also shown to modulate the relationship between HIV and penile carcinoma, with a higher risk of cancer in Hispanic, compared with Caucasian, HIV-positive men. This review has collated data from diverse sources to improve understanding of the relationship between HIV and penile cancer. This relationship has been quantitatively and qualitatively characterised and highlights areas that require further enquiry.