title: Penile cancer disparities in Puerto Rican men as compared to the United States population.
abstract: OBJECTIVE
  This study compares incidence and mortality of penile cancer in Puerto Rico (PR) with other racial/ethnic groups in the United States (US) and evaluates the extent in which socioeconomic position index (SEP) or its components influence incidence and mortality in PR.
  
  
  METHODS
  Age-standardized rates were calculated for incidence and mortality based on data from the PR Cancer Registry and the US National Cancer Institute's Surveillance, Epidemiology and End Results program, using the direct method.
  
  
  RESULTS
  PR men had approximately 3-fold higher incidence of penile cancer as compared to non-Hispanic white (Standardized rate ratio [SRR]: 3.33; 95%CI=2.80-3.95). A higher incidence of penile cancer was also reported in PR men as compared to non-Hispanic blacks and Hispanics men. Mortality from penile cancer was also higher for PR men as compared to all other ethnic/racial groups. PR men in the lowest SEP index had 70% higher incidence of penile cancer as compared with those PR men in the highest SEP index. However, the association was marginally significant (SRR: 1.70; 95%CI=0.97, 2.87). Only low educational attainment was statistically associated with higher penile cancer incidence (SRR: 2.18; 95%CI=1.42-3.29).
  
  
  CONCLUSIONS
  Although penile cancer is relatively uncommon, our results support significant disparities in the incidence and mortality rates among men in PR. Low educational attainment might influence the high incidence of penile cancer among PR men. Further studies are strongly recommended to explore these disparities.
authors.affiliation: Department of Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, Puerto Rico.
authors.forename: Vivian
authors.initials: V
authors.lastname: Colón-López
authors.forename: Ana P
authors.initials: AP
authors.lastname: Ortiz
authors.forename: Marievelisse
authors.initials: M
authors.lastname: Soto-Salgado
authors.forename: Mariela
authors.initials: M
authors.lastname: Torres-Cintrón
authors.forename: Curtis A
authors.initials: CA
authors.lastname: Pettaway
authors.forename: Antonio
authors.initials: A
authors.lastname: Puras-Báez
authors.forename: Magaly
authors.initials: M
authors.lastname: Martínez-Ferrer
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez
mesh_terms: D017677:Age Distribution; D000368:Aged; D004812:Epidemiologic Methods; D005006:Ethnicity; D006801:Humans; D008297:Male; D008875:Middle Aged; D010412:Penile Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D011647:Puerto Rico / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology