title: Increased incidence of penile cancer and high-grade penile intraepithelial neoplasia in Denmark 1978-2008: a nationwide population-based study.
abstract: OBJECTIVE
  To assess the trends in incidence of penile cancer during 1978-2008 and high-grade penile intraepithelial neoplasia (PIN2/3) during 1998-2008 in Denmark.
  
  
  METHODS
  Using two nationwide registries, we estimated age- and period-specific incidence rates. Log-linear Poisson regression analysis was used to estimate average annual percentage change (AAPC) and 95% confidence intervals (CI).
  
  
  RESULTS
  We identified 1,488 men with penile cancer and 285 men with PIN2/3. The incidence of penile cancer increased from 1.0 to 1.3 per 100,000 men-years in 1978-1979 to 2006-2008; this represented an AAPC of 0.8% (95% CI: 0.17-1.37). Squamous cell carcinoma (SCC) was the most common histological type (91.7%). The median age at diagnosis was 67 years, and the age-specific incidence rate of penile SCC increased with increasing age. The incidence rate of PIN2/3 increased significantly (0.5 to 0.9 per 100,000 men-years) in 1998-1999 to 2006-2008, and this represented an AAPC of 7.1% (95% CI: 3.30-11.05).
  
  
  CONCLUSIONS
  The incidence of penile cancer increased in 1978-2008 in Denmark, and the same applied to PIN2/3 in 1998-2008. A high prevalence of human papillomavirus (HPV) and a low circumcision rate in Denmark may partly explain our results.
authors.affiliation: Department of Viruses, Hormones and Cancer, Institute of Cancer Epidemiology, Danish Cancer Society, 2100 Copenhagen, Denmark.
authors.forename: Birgitte
authors.initials: B
authors.lastname: Baldur-Felskov
authors.forename: Charlotte Gerd
authors.initials: CG
authors.lastname: Hannibal
authors.forename: Christian
authors.initials: C
authors.lastname: Munk
authors.forename: Susanne K
authors.initials: SK
authors.lastname: Kjaer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D002944:Circumcision, Male / Q000009:adverse effects; D016001:Confidence Intervals; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000821:virology; D010412:Penile Neoplasms / Q000453:epidemiology* / Q000473:pathology / Q000821:virology; D010413:Penis / Q000473:pathology; D015995:Prevalence; D012044:Regression Analysis; D055815:Young Adult