Institute of Urology, Division of Surgical and Interventional Sciences, University College London, 25 Grafton Way, London, United Kingdom.
Urology. 2010 Aug;76(2 Suppl 1):S24-35. doi: 10.1016/j.urology.2010.04.007.
Relatively little evidence is available in the published studies on the prevention of penile cancer and premalignant conditions of the penis. The present review examined the current evidence available in preventing penile cancer and pathologic subtypes of premalignant conditions and their treatment. The recommendations made in the present review formulate the basis of the recent 2009 International Consultation on Urologic Disease Consensus Publishing Group.
The association of human papillomavirus subtypes and penile cancer is well-established, although the etiology, natural history, and treatment of premalignant lesions have mainly been reported in retrospective case series with short-term follow-up. The exact pathologic role of chronic inflammatory conditions, such as balanitis xerotica obliterans in the etiology of penile cancer remains largely unknown.
Some of the potential strategies for the prevention of penile cancer could include circumcision, reducing the risk of transmission of penile human papillomavirus infection with male vaccination, early treatment of phimosis, smoking cessation, and hygienic measures. Implementing some of these measures would require extensive cost/benefit analysis, with significant changes in the global health policy.
Owing to the current levels of evidence from published studies, firm guidelines cannot be formulated for the treatment of premalignant conditions, although preventative measures, such as reducing human papillomavirus transmission, could become strategic health targets.
在已发表的研究中，关于阴茎癌和阴茎癌前病变的预防，证据相对较少。本综述检查了目前可用于预防阴茎癌和癌前病变及其治疗的现有证据。本综述中的建议构成了最近 2009 年国际泌尿科疾病共识出版小组的基础。
人乳头瘤病毒亚型与阴茎癌的相关性已得到充分证实，尽管阴茎癌前病变的病因、自然史和治疗主要以短期随访的回顾性病例系列报告。慢性炎症性疾病（如干燥性龟头炎）在阴茎癌病因中的确切病理作用在很大程度上仍不清楚。
一些预防阴茎癌的潜在策略可能包括包皮环切术、通过男性疫苗接种减少阴茎人乳头瘤病毒感染的传播风险、早期治疗包茎、戒烟和卫生措施。实施其中一些措施需要进行广泛的成本效益分析，并对全球卫生政策进行重大改变。
由于目前发表的研究证据水平，无法为癌前病变的治疗制定明确的指南，但可以将减少人乳头瘤病毒传播等预防措施作为战略卫生目标。
