Penile cancer and penile amputations rising globally

Recent global health reports indicate a concerning rise in the incidence of penile cancer, a rare but increasingly prevalent disease affecting men. According to researchers from Sun Yat-Sen University in China, the number of penile cancer cases is expected to increase by 77% globally over the next 26 years. This significant uptick has been noted across various regions, with Germany seeing a 50% rise between 1961 and 2012 and the UK experiencing a notable spike in cases. While traditionally more common in developing nations, this increase is now being observed across many European countries as well.

The impact on Brazil and Uganda

Brazil reports one of the highest incidences of penile cancer in the world, only second to Uganda. Over the decade spanning 2012 to 2022, Brazil witnessed 21,000 new cases and 4,000 deaths, with a distressing number of 6,500 men undergoing amputation due to the disease. Health experts in Brazil have linked these high numbers to insufficient HPV vaccination coverage, which remains below the ideal 90% threshold – 57% for girls and just 40% for boys.

Symptoms and early detection

Penile cancer can manifest through various symptoms, including discharge, a change in the colour or skin texture of the penis, and a decrease in sex drive. Early detection plays a crucial role in preventing severe outcomes such as amputation. Men, particularly those in their 60s, are encouraged to seek medical advice if they notice any unusual changes, as early stages of penile cancer are more manageable and often curable.

Prevention through personal hygiene and safe practices

Many urologist, emphasises the importance of personal hygiene and protected sexual activity in reducing the risk of penile cancer. Factors contributing to higher risk include poor genital hygiene, unprotected sexual intercourse, and not being circumcised. Circumcision, particularly if performed in childhood, has been shown to significantly decrease the risk of developing penile cancer by reducing the chance of infections and other complications that can lead to cancerous changes.

The critical role of HPV and vaccination

Human papillomavirus (HPV) is identified as one of the main risk factors for penile cancer. The virus, which can be transmitted during sexual contact, has different strains, some of which are more likely to lead to cancer if not cleared by the body’s immune system. Vaccination against HPV is highly effective in preventing these high-risk strains. Despite this, vaccination rates in many countries remain low due to misinformation, vaccine hesitancy, and lack of comprehensive vaccination campaigns.

The global scenario

The study published in the journal JMIR Public Health and Surveillance further highlights the growing prevalence of penile cancer worldwide, with the highest rates observed in Uganda (2.2 per 100,000), followed by Brazil (2.1 per 100,000), and Thailand (1.4 per 100,000).

The ageing population is one of the factors contributing to this increase, as penile cancer most frequently affects older men.

Mitigating the disease burden

To counteract the rising trend of penile cancer, it is imperative for global health initiatives to focus on effective prevention strategies. This includes promoting better hygiene, expanding HPV vaccination programs to reach optimal coverage levels, and encouraging safe sexual practices through education and access to protective measures like condoms.

Stories from the frontline

The human side of penile cancer is poignantly illustrated by the story of Martin (not his real name), a British pensioner who has been residing in Pattaya-Thailand for more than a decade and who was just recently diagnosed with the condition. Initially dismissed as a benign issue when he discovered a small wart on his penis, the wart grew and he suffered urination problems and pain. His condition was later diagnosed as penile cancer, leading to partial amputation. Not only is he currently suffering from depression and a variety of psychological issues, but his quality of life has deteriorated as he is constantly in pain coupled with issues of using the restroom etc. Martin’s experience underscores the psychological and physical toll of the disease, highlighting the importance of awareness and early medical intervention.

Enhancing public health strategies

Looking ahead, the Global Cancer Registries predict a significant increase in penile cancer incidences by 2050. This underscores the need for enhanced public health strategies that not only focus on treatment but also on comprehensive preventive measures. Such strategies should include improving genital hygiene, ensuring wider access to HPV vaccines, and promoting safe sexual practices.

While penile cancer remains one of the rarer cancers, its impact is profound, and its incidence is on the rise globally. Addressing this issue requires a multifaceted approach involving improved public health education, better access to preventive measures, and a concerted effort to debunk myths surrounding HPV vaccination. Through these efforts, it is possible to reduce the global burden of penile cancer and improve outcomes for men worldwide, ensuring that future generations face a lower risk of this serious disease.

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