Harvard Medical School, Boston, Massachusetts.
Department of Radiation Oncology, Massachusetts General Hospital, Boston, Massachusetts.
Clin Genitourin Cancer. 2024 Oct;22(5):102156. doi: 10.1016/j.clgc.2024.102156. Epub 2024 Jul 6.
Penile cancer is rare in the United States (US); however, disparities have been found in the incidence, treatment, and outcomes of penile cancer. There is a need for evaluation of recent trends in penile cancer mortality, incidence, and place of death across all demographics.
Using the CDC WONDER database, penile cancer-specific mortality (PNCSM) trends in the US were evaluated from 1999 to 2020 by race/ethnicity, age group, census region, and place of death. Penile cancer incidence trends for the US from 1995 to 2019 were gathered from the NAACCR database. Average annual percent changes for mortality and incidence rates were determined using Joinpoint regression modeling. Univariable and multivariable logistic regression were used to evaluate independent predictors associated with place of death.
From 1999 to 2020, 5833 people died from penile cancer in the US. Overall PNCSM increased by 1.8% per year from 1999-2020 (95% CI, 1.3%, 2.2%). Non-Hispanic White patients and Hispanic patients had increasing PNCSM rates from 1999-2020 (2.1 [95% CI, 1.5%, 2.7%]; 1.9 [95% CI, 1.0%, 2.8%], respectively). From the place of death analysis, Hispanic patients were at higher odds of dying at home or hospice when compared to non-Hispanic White patients (adjusted odds ratio [aOR] = 1.19, P = .045). Age-adjusted incidence rates for all stages of penile cancer increased significantly from 1995-2016 (AAPC, 0.7% [95% CI, 0.4%, 1.0%]), driven by regional and distant penile cancer incidence rates (AAPC 1995-2019, regional: 2.0% [95% CI, 1.7%, 2.4%]; AAPC 1995-2019, distant: 2.5% [95% CI, 1.8%, 3.1%]).
The increasing penile cancer-specific mortality and incidence rates indicate the need for further improvements in screening, diagnosis, and treatment. Widespread efforts across all demographics are needed to ensure early detection of the disease.
阴茎癌在美国较为罕见；然而，在阴茎癌的发病率、治疗和预后方面存在差异。需要评估所有人群中阴茎癌死亡率、发病率和死亡地点的最新趋势。
使用疾病预防控制中心的 WONDER 数据库，评估了 1999 年至 2020 年美国按种族/族裔、年龄组、普查区域和死亡地点划分的阴茎癌特异性死亡率（PNCSM）趋势。从 1995 年至 2019 年，从 NAACCR 数据库收集了美国的阴茎癌发病率趋势。使用 Joinpoint 回归模型确定死亡率和发病率的平均年变化百分比。使用单变量和多变量逻辑回归评估与死亡地点相关的独立预测因素。
1999 年至 2020 年，美国有 5833 人死于阴茎癌。1999 年至 2020 年，PNCSM 总体每年增长 1.8%（95%CI，1.3%，2.2%）。非西班牙裔白人患者和西班牙裔患者的 PNCSM 率从 1999 年至 2020 年呈上升趋势（2.1%[95%CI，1.5%，2.7%]；1.9%[95%CI，1.0%，2.8%]）。从死亡地点分析，与非西班牙裔白人患者相比，西班牙裔患者在家或临终关怀机构死亡的可能性更高（调整后的优势比[aOR]=1.19，P=0.045）。所有分期的阴茎癌的年龄调整发病率从 1995 年至 2016 年显著增加（AAPC，0.7%[95%CI，0.4%，1.0%]），这主要是由于区域性和远处阴茎癌发病率的增加（AAPC 1995-2019 年，区域性：2.0%[95%CI，1.7%，2.4%]；AAPC 1995-2019 年，远处：2.5%[95%CI，1.8%，3.1%]）。
阴茎癌特异性死亡率和发病率的上升表明需要进一步改善筛查、诊断和治疗。需要在所有人群中开展广泛的工作，以确保早期发现疾病。
