Risk factors for penile intraepithelial neoplasia: A population-based register study in Sweden, 2000–2012

Abstract

Studies on risk factors for penile intraepithelial neoplasia have been small in size, have not distinguished penile intraepithelial neoplasia from invasive cancer, and have relied on self-reported information. This study investigated risk factors for penile intraepithelial neoplasia in a cohort of 580 penile intraepithelial neoplasia cases and 3,436 controls using information from 7 Swedish registers. Cases with penile intraepithelial neoplasia had increased odds ratios (ORs) for inflammatory skin diseases (14.7, 95% CI 6.5–33.4) including lichen planus (12.0, 95% CI 3.0–48.0), indicating lichen planus to be an important risk factor. Increased ORs were also observed for diseases of the prepuce (4.0, 95% CI 2.2–7.4), immunosuppressive drugs (5.0, 95% CI 2.5–9.8), penile surgical procedures (4.8, 95% CI 2.2–10.8), balanitis (9.2, 95% CI 5.0–16.8), genital warts (9.9, 95% CI 4.3−22.7) and organ transplantation (7.0, 95% CI 2.4–20.8). This study demonstrates important risk factors for penile intraepithelial neoplasia, providing knowledge that can help prevent the development of penile cancer.