title: Penile cancer--prevention and premalignant conditions.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Urology, Division of Surgical and Interventional Sciences, University College London, 25 Grafton Way, London, United Kingdom. sminhas@btinternet.com
authors.forename: Suks
authors.initials: S
authors.lastname: Minhas
authors.forename: Andreas
authors.initials: A
authors.lastname: Manseck
authors.forename: Stephen
authors.initials: S
authors.lastname: Watya
authors.forename: Paul K
authors.initials: PK
authors.lastname: Hegarty
mesh_terms: D002278:Carcinoma in Situ / Q000473:pathology; D002944:Circumcision, Male; D006801:Humans; D008297:Male; D030361:Papillomavirus Infections / Q000473:pathology; D010412:Penile Neoplasms / Q000473:pathology / Q000517:prevention & control*; D011230:Precancerous Conditions; D012307:Risk Factors