title: Population-based survival of penile cancer patients in Europe and the United States of America: no improvement since 1990.
abstract: BACKGROUND
  Penile cancer is a rare neoplasm in Western countries, and detailed studies on trends in population-based survival of penile cancer have never been published before. We examined population-based trends in survival in Europe and the United States of America (USA).
  
  
  METHODS
  Data from 3297 European and 1820 American penile cancer patients, contributed by 12 European cancer registries and the Surveillance, Epidemiology, and End Results (SEER) Program of the USA were included in this study. Period analysis techniques were used to examine relative survival trends overall, as well as for four geographic regions in Europe, and for the age groups 15-54, 55-64, 65-74 and 75+ for both populations between 1990-1995 and 2002-2007. Survival trends were assessed in a multiple regression model of relative excess risk including period of diagnosis, age and continent.
  
  
  RESULTS
  The 5-year relative survival of penile cancer patients increased statistically non-significantly from 65% to 70% in Europe and decreased (significantly) from 72% to 63% in the USA. Trends in age-specific 5-year relative survival did not find any significant improvement in either Europe or the USA. The multiple regression analysis confirmed the lack of survival trend, and found significantly higher relative excess risk with age, and, apparently due to lower survival before 2002-2007, higher risk in Europe.
  
  
  CONCLUSIONS
  Survival for penile cancer patients has not improved in either Europe or the USA since at least 1990. The reasons for the decrease of survival in the USA remain unknown and to be explored. Stronger international cooperation in clinical research may be important to facilitate clinical progress in treatment and thereby improvement of survival of this rare malignancy.
authors.affiliation: Eindhoven Cancer Registry/Comprehensive Cancer Centre South, P.O. Box 231, 5600 AE Eindhoven, The Netherlands. research@ikz.nl
authors.forename: R H A
authors.initials: RH
authors.lastname: Verhoeven
authors.forename: M L G
authors.initials: ML
authors.lastname: Janssen-Heijnen
authors.forename: K U
authors.initials: KU
authors.lastname: Saum
authors.forename: R
authors.initials: R
authors.lastname: Zanetti
authors.forename: A
authors.initials: A
authors.lastname: Caldarella
authors.forename: B
authors.initials: B
authors.lastname: Holleczek
authors.forename: D H
authors.initials: DH
authors.lastname: Brewster
authors.forename: T
authors.initials: T
authors.lastname: Hakulinen
authors.forename: S
authors.initials: S
authors.lastname: Horenblas
authors.forename: H
authors.initials: H
authors.lastname: Brenner
authors.forename: A
authors.initials: A
authors.lastname: Gondos
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005060:Europe / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000453:epidemiology / Q000401:mortality*; D011159:Population Surveillance / Q000379:methods*; D012042:Registries / Q000706:statistics & numerical data*; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors; D018426:SEER Program / Q000706:statistics & numerical data; D016019:Survival Analysis; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D055815:Young Adult