Racial and economic disparities in the treatment of penile squamous cell carcinoma: Results from the National Cancer Database

Sharma, Pranav; Ashouri, Kenan; Zargar‐Shoshtari, Kamran; Luchey, Adam; Spiess, Philippe E.

doi:10.1016/j.urolonc.2015.10.001

Cited by 36 publications

(35 citation statements)

References 17 publications

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“…In males, higher penile cancer rates among HIV‐infected Hispanics versus NHWs are consistent with patterns in the general population . A lack of circumcision is an important risk factor for penile cancer, and circumcision is more common among US NHW infants than other racial/ethnic groups . Although results are inconsistent, associations have been reported between male circumcision and lower HPV incidence and increased HPV clearance for certain HPV types, and randomized trials have shown a protective effect of this medical procedure for HPV and other sexually transmitted infections .…”

Section: Discussionsupporting

confidence: 57%

“…28 A lack of circumcision is an important risk factor for penile cancer, and circumcision is more common among US NHW infants than other racial/ethnic groups. 9,29 Although results are inconsistent, associations have been reported between male circumcision and lower HPV incidence and increased HPV clearance for certain HPV types, 30 and randomized trials have shown a protective effect of this medical procedure for HPV and other sexually transmitted infections. 31 Other potential risk factors for penile cancer include tobacco use, poor genital hygiene, and a lower socioeconomic status.…”

Section: Discussionmentioning

confidence: 99%

“…Anal and cervical cancer rates among PLWH have decreased in recent years, and this could be due to improvements in HIV treatment; however, the number of new HPV‐related cancer diagnoses has increased because of the growth and aging of the US HIV population . In the United States, incidence rates of HPV‐related cancers and survival differ by race/ethnicity . Hispanics have elevated cervical and penile cancer rates but not elevated vaginal and vulvar cancer rates, whereas anal cancer rates are higher in Hispanic women but lower in Hispanic men .…”

Section: Introductionmentioning

confidence: 99%

“…7 In the United States, incidence rates of HPV-related cancers and survival differ by race/ethnicity. [8][9][10] Hispanics have elevated cervical and penile cancer rates but not elevated vaginal and vulvar cancer rates, 11 whereas anal cancer rates are higher in Hispanic women but lower in Hispanic men. 1 PLWH are at increased risk for HPVassociated cancers because both infections are transmitted sexually, and HPV incidence and persistence are high in the setting of immunosuppression.…”

Section: Introductionmentioning

confidence: 99%

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Disparities in human papillomavirus–related cancer incidence and survival among human immunodeficiency virus–infected Hispanics living in the United States

Ortiz

Engels

Nogueras‐González

et al. 2018

Cancer

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Background Human papillomavirus (HPV) causes 10% of cancers among human immunodeficiency virus (HIV)–infected people in the United States. Because Hispanics are disproportionally affected by the HIV epidemic and by infection‐related cancers, this study compared incidence rates for HPV‐related cancers and survival between Hispanics and non‐Hispanic whites (NHWs) and non‐Hispanic blacks (NHBs) in the HIV‐infected US population. Methods Based on data from the HIV/AIDS Cancer Match Study, standardized incidence ratios (SIRs) were used to estimate cancer risk in HIV‐infected Hispanics and the general US Hispanic population. Among HIV‐infected people, cancer rates were compared with incidence rate ratios (IRRs), and survival was compared with hazard ratios between Hispanics and NHWs and NHBs. Results Five hundred two HPV‐related cancers occurred in 864,067 person‐years of follow‐up among HIV‐infected Hispanics. Except for oropharyngeal cancer, the risk of HPV‐related cancers was higher among HIV‐infected Hispanics than in the general population (SIR range, 3.59 [cervical cancer] to 18.7 [anal cancer in men]). Among HIV‐infected females, Hispanics had higher cervical cancer rates than NHWs (IRR, 1.70; 95% confidence interval [CI], 1.19‐2.43) but lower vulvar cancer rates than NHWs (IRR, 0.40; 95% CI, 0.24‐0.67) and NHBs (IRR, 0.62; 95% CI, 0.41‐0.95). Among HIV‐infected males, Hispanics had higher penile cancer rates than NHWs (IRR, 2.60; 95% CI, 1.36‐4.96) but lower anal cancer rates than NHWs (IRR, 0.54; 95% CI, 0.46‐0.63) and NHBs (IRR, 0.65; 95% CI, 0.56‐0.77). Among HIV‐infected Hispanics, 5‐year survival was greater than 50% across HPV‐related cancer types, with no major differences by racial/ethnic group. Conclusions HIV‐infected Hispanics have an elevated risk for HPV‐related cancers. Similarly to the general population, HIV‐infected Hispanics have higher rates of cervical and penile cancer than NHWs and NHBs. HPV vaccination should be promoted among HIV‐infected individuals to reduce the burden of HPV‐related cancers.

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Section: Discussionsupporting

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Disparities in human papillomavirus–related cancer incidence and survival among human immunodeficiency virus–infected Hispanics living in the United States

Ortiz

Engels

Nogueras‐González

et al. 2018

Cancer

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“…Prior studies have shown that racial disparities do exist for the treatment and prognosis of penile cancer. Two studies that used the NCDB found that black race was associated with higher tumour stage at diagnosis and lower overall survival . However, neither demonstrated black race as a significant predictor of node‐positive disease.…”

Section: Discussionmentioning

confidence: 99%

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

et al. 2019

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ObjectiveTo evaluate the predictive nature of several clinicopathological variables by developing a nomogram predictive for lymph node-positive disease using the National Cancer Database cohort of patients with squamous cell carcinoma of the penis. MethodsStepwise logistic regression was used to find the best-fit model; remaining clinical variables were used to create a nomogram to predict the probability of lymph node-positive disease. ResultsOn multivariate analysis, high pathological grade (3-4 vs 1: odds ratio [OR] 3.27, 95% confidence interval [CI] 1.70-6.29; 2 vs 1: OR 2.58, 95% CI 1.39-4.79 [P = 0.002]), lymphovascular invasion (OR 2.49, 95% CI 1.61-3.84 [P < 0.001]), and positive clinical lymph node status (N1 vs N0: OR 20.0, 95% CI 11.4-35.7; N2 vs N0: OR 27.8, 95% CI 14.1-55.6; N3 vs N0: OR 49.2, 95% CI 14.8-162.8 [P < 0.001]) were predictors of lymph node metastasis in penile cancer. The bootstrap-corrected concordance index of this nomogram was 0.880. ConclusionUsing tumour grade, tumour lymphovascular invasion and clinical lymph node status, we developed a nomogram highly predictive of pathologial lymph node metastasis that, after further external validation, could be helpful in the surgical decision-making process.

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Competing‐risks model for predicting the prognosis of penile cancer based on the SEER database

Yang

Pan

et al. 2019

Cancer Medicine

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Objectives This study performed a competing‐risks analysis using data from the SEER database on penile cancer patients with the aim of identifying more accurate prognostic factors. Methods Data on patients with penile cancer were extracted from the SEER database. A univariate analysis used the cumulative incidence function and Gray's test, while multivariate analysis was performed using the Fine‐Gray model. Cumulative hazards were compared with a competing‐risks model constructed using Kaplan‐Meier estimation. Results The multivariate Fine‐Gray analysis indicated that being black (HR = 1.51, 95%CI: 1.10‐2.07, P = .01), AJCC stage II (HR = 1.94, 95%CI: 1.36‐2.77, P < .001), AJCC stage III (HR = 1.98, 95%CI: 1.34‐2.91, P < .001), tumor size > 5 cm (HR = 2.23, 95%CI: 1.33‐3.72, P < .05), and TNM stages N1 (HR = 2.49, 95%CI: 1.71‐3.61, P < .001), N2 (HR = 3.25, 95%CI: 2.18‐4.84, P < .001), N3 (HR = 5.05, 95%CI: 2.69‐9.50, P < .001), and M1 (HR = 2.21, 95%CI: 1.28‐3.84, P < .05) were statistically significant. The results obtained using multivariate Cox regression were different, while Kaplan‐Meier curve analysis led to an overestimation of the cumulative risk of the patient. Conclusions This study established a competing‐risks analysis model for the first time based on the SEER database for the risk assessment of penile cancer patients. The results may help clinicians to better understand penile cancer and provide these patients with more appropriate support.

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Racial and economic disparities in the treatment of penile squamous cell carcinoma: Results from the National Cancer Database

Cited by 36 publications

References 17 publications

Disparities in human papillomavirus–related cancer incidence and survival among human immunodeficiency virus–infected Hispanics living in the United States

Disparities in human papillomavirus–related cancer incidence and survival among human immunodeficiency virus–infected Hispanics living in the United States

A National Cancer Database‐based nomogram to predict lymph node metastasis in penile cancer

Competing‐risks model for predicting the prognosis of penile cancer based on the SEER database

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