Goodman Marc T, Hernandez Brenda Y, Shvetsov Yurii B
Etiology Program, Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala Street, Honolulu, HI 96813.
Cancer Epidemiol Biomarkers Prev. 2007 Sep;16(9):1833-9. doi: 10.1158/1055-9965.EPI-07-0221.
Penile cancer is an uncommon malignancy, so few descriptive or analytic studies have been reported in the literature. The objective of this analysis was to describe the distribution of penile cancer in the United States by demographic, pathologic, and clinical features.
Penile cancer among 6,539 men was identified through 29 population-based registries in the United States during the period 1995-2003. These registries were estimated to represent 68% of the U.S. population. Age-adjusted incidence rates were calculated per million population using counts derived from the 2000 U.S. census. A subset of nine registries was used to examine time trends in penile cancer between 1973 and 2003.
Squamous cell carcinomas were the most common histologic type of penile cancer, representing 93% of all malignancies. Hispanic men had the highest age-adjusted incidence rates per million for penile cancer (6.58 per million), followed by Blacks (4.02 per million), Whites (3.90 per million), American Indians (2.81 per million), and Asian-Pacific Islanders (2.40 per million). The highest rates of penile cancer were found among Hispanic men (46.9 per million) and Black men (36.2 per million) of ages >/=85 years. Penile malignancy was rare among males under age 20 years. Time trend analysis supported a significant decrease in the incidence of penile cancer for Blacks (annual percent change, -1.9%) and Whites (annual percent change, -1.2%). The majority (61%) of penile cancers were diagnosed at a localized stage among all racial and ethnic groups, although Hispanic and Black men tended to be diagnosed at more advanced stages than Whites. No racial or ethnic differences in tumor grade were identified. The incidence of penile cancer was highest in the South (4.42 per million) and lowest in the West (3.28 per million) of the United States. The highest age-adjusted incidence rate was found among Black men in the South (4.77 per million) and the lowest rate among Asian-Pacific Islanders in the West (1.84 per million).
This analysis showed significant racial/ethnic and regional variation in the incidence of penile cancer. The high rate of penile cancer among Hispanic and Southern Black men suggests differences in risk factors for this malignancy, such as circumcision, hygiene, or human papillomavirus exposure.
阴茎癌是一种罕见的恶性肿瘤，因此文献中报道的描述性或分析性研究较少。本分析的目的是按人口统计学、病理学和临床特征描述美国阴茎癌的分布情况。
通过美国29个基于人群的登记处，在1995 - 2003年期间识别出6539名男性中的阴茎癌病例。据估计，这些登记处代表了68%的美国人口。使用2000年美国人口普查得出的计数，计算每百万人口的年龄调整发病率。九个登记处的一个子集用于研究1973年至2003年期间阴茎癌的时间趋势。
鳞状细胞癌是阴茎癌最常见的组织学类型，占所有恶性肿瘤的93%。西班牙裔男性每百万人口中阴茎癌的年龄调整发病率最高（每百万6.58例），其次是黑人（每百万4.02例）、白人（每百万3.90例）、美国印第安人（每百万2.81例）和亚太岛民（每百万2.40例）。阴茎癌发病率最高的是年龄≥85岁的西班牙裔男性（每百万46.9例）和黑人男性（每百万36.2例）。20岁以下男性中阴茎恶性肿瘤罕见。时间趋势分析支持黑人（年变化百分比，-1.9%）和白人（年变化百分比，-1.2%）阴茎癌发病率显著下降。在所有种族和族裔群体中，大多数（61%）阴茎癌在局部阶段被诊断出来，尽管西班牙裔和黑人男性往往比白人在更晚期被诊断出来。未发现肿瘤分级存在种族或族裔差异。美国南部阴茎癌发病率最高（每百万4.42例），西部最低（每百万3.28例）。年龄调整发病率最高的是南部黑人男性（每百万4.77例），最低的是西部亚太岛民（每百万1.84例）。
该分析显示阴茎癌发病率存在显著的种族/族裔和地区差异。西班牙裔和美国南部黑人男性阴茎癌发病率高表明该恶性肿瘤的危险因素存在差异，如包皮环切、卫生状况或人乳头瘤病毒暴露情况。
