Is penile cancer caused by HPV?

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Question: Is penile cancer caused by HPV?

Answer: Sometimes.

Not all penile cancers are caused by the human papillomavirus (HPV). However, research suggests that many penis cancers probably are. Several studies have found that more than half of penile cancers test positive for high risk HPV DNA. This is not the same as saying that HPV has caused any cancer in which it is found,. Still, it is likely to be a contributing factor in many or most of such cancers.

There is other evidence that HPV plays a significant role in the development of penis cancers. Scientists have also demonstrated that there is a  behavioral component to penile cancer risk. At least one study has also found an association between penile cancer and heterosexual oral sex. Remember, oral sex is also associated with HPV infection, and oral cancer caused by HPV. That's another reason to suspect that HPV plays a significant role in penile cancer risk. It may not be a huge risk, overall. Still, it should give people additional motivation to use condoms for blow jobs ... particularly when they can be so much fun to put on.

Unfortunately, unlike at other sites, it is unclear whether HPV related penis cancers are more invasive than non viral cancers. Some studies have shown that these cancers may be more likely to spread to the lymph nodes. This type of invasive cancer is generally associated with worse outcomes.

Other studies, however, have found the opposite result. Namely, they've found that HPV-related tumors are less aggressive.

Reducing Your Risk for HPV Related Penile Cancer

There are two basic ways to reduce your risk for HPV-related penis cancers. The first is to consistently practice safe sex. Using condoms for vaginal sex, anal sex, and oral sex will reduce the likelihood of you being exposed to penile HPV.

The second thing you can do is consider getting an HPV vaccine. Admittedly, this is likely to be more useful for men who have not become sexually active. However, men who have had relatively few sexual partners may also benefit from HPV vaccination. (Men who have had many partners have likely been exposed already. HPV is an extremely common STD.) 

Other Risk Factors for Penile Cancer

Penis cancer is also associated with other sexual risk factors as well as men's health conditions, such as phimosis and balanitis. Smoking and HIV are additional risk factors. Penile cancer is rare in industrialized nations but is much more common in Africa, South America, and Asia.

Source:
Chaux A, Velazquez EF, Barreto JE, Ayala E, Cubilla AL. New pathologic entities in penile carcinomas: an update of the 2004 world health organization classification. Semin Diagn Pathol. 2012 May;29(2):59-66.

Madsen BS et al. (2008) "Risk factors for squamous cell carcinoma of the penis-population-based case-control study in Denmark." Cancer Epidemiology Biomarkers and Prevention 17:2683-2691.

Mentrikoski MJ, Stelow EB, Culp S, Frierson HF Jr, Cathro HP. Histologic and immunohistochemical assessment of penile carcinomas in a North American population. Am J Surg Pathol. 2014 Oct;38(10):1340-8.

Sanchez DF, Cañete S, Fernández-Nestosa MJ, Lezcano C, Rodríguez I, Barreto J, Alvarado-Cabrero I, Cubilla AL. HPV- and non-HPV-related subtypes of penile squamous cell carcinoma (SCC): Morphological features and differential diagnosis  according to the new WHO classification (2015). Semin Diagn Pathol. 2015 May;32(3):198-221. doi: 10.1053/j.semdp.2014.12.018.

Steinestel J, Al Ghazal A, Arndt A, Schnoeller TJ, Schrader AJ, Moeller P, Steinestel K. The role of histologic subtype, p16(INK4a) expression, and presence of human papillomavirus DNA in penile squamous cell carcinoma. BMC Cancer. 2015 Apr 3;15:220. doi: 10.1186/s12885-015-1268-z.

Vogt SL, Gravitt PE, Martinson NA, Hoffmann J, D'Souza G. Concordant Oral-Genital HPV Infection in South Africa Couples: Evidence for Transmission. Front Oncol. 2013 Dec 12;3:303. doi: 10.3389/fonc.2013.00303.

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