Swedish National Penile Cancer Register: incidence, tumour characteristics, management and survival.
OBJECTIVE
To assess penile cancer incidence, stage distribution, adherence to guidelines and prognostic factors in a population-based setting.


METHODS
The population-based Swedish National Penile Cancer Register (NPECR) contains detailed information on tumour characteristics and management patterns. A total of 1 678 men with primary squamous cell carcinoma of the penis identified in the NPECR between 2000 and 2012 were included in the study.


RESULTS
The mean age-adjusted incidence of penile cancer was 2.1/100 000 men, remaining virtually unchanged during the study period. At diagnosis, 14 and 2% of the men had clinical N+ and M+ disease, respectively. Most men were staged pTis (34%), pT2 (19%), or pT1 (18%), while stage information was unavailable for 18% of the men. Organ-preserving treatment was used in 71% of Tis-T1 tumours. Of men with cN0 and ≥pT1G2 disease, 50% underwent lymph node staging, while 74% of men with cN1-3 disease underwent lymph node dissection. The overall 5-year relative survival rate was 82%. Men aged ≥40 years and those with pT2-3, G2-3 and N+ tumours had worse outcomes.


CONCLUSIONS
The incidence of penile cancer in Sweden is stable. Most men presented with localized disease, and the proportion of non-invasive tumours was high. During the period under study, adherence to guidelines was suboptimum. The overall 5-year relative survival rate was 82%. Older age, increasing tumour stage and grade, and increasing lymph node stage were associated with poorer survival.
Department of Urology, Örebro University Hospital, Örebro, Sweden.
Peter
P
Kirrander
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
Amir
A
Sherif
Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden.
Bengt
B
Friedrich
Regional Cancer Centre Uppsala-Örebro, Uppsala University Hospital, Uppsala, Sweden.|Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Mats
M
Lambe
Department of Urology, Skåne University Hospital, Malmö, Sweden.
Ulf
U
Håkansson
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology*; D019983:Guideline Adherence; D017408:Guidelines as Topic; D006801:Humans; D015994:Incidence; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010412:Penile Neoplasms / Q000401:mortality / Q000473:pathology*; D058996:Quality Improvement / Q000458:organization & administration*; D012017:Referral and Consultation; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D015996:Survival Rate; D013548:Sweden / Q000453:epidemiology
TNM; incidence; penile cancer; population-based; prognostic factors; survival