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. 2022 Jun;129(6):752-759.
doi: 10.1111/bju.15688. Epub 2022 Jan 24.

Incidence of penile intraepithelial neoplasia and treatment strategies in Sweden 2000-2019

Sinja Kristiansen  1 , Christian Torbrand  2   3 , Åke Svensson  1 , Ola Forslund  4 , Carina Bjartling  5
Affiliations

Incidence of penile intraepithelial neoplasia and treatment strategies in Sweden 2000-2019

Sinja Kristiansen et al. BJU Int. 2022 Jun.

Abstract

Objectives: To analyse the incidence, treatment strategies and complications associated with penile intraepithelial neoplasia (PeIN) in Sweden over a period of 20 years.

Materials and methods: Data on PeIN from the Swedish National Penile Cancer Register were analysed regarding treatment in relation to age, size of the PeIN lesion, localization of the PeIN lesion and complications using chi-squared tests and logistic regression. The incidence of PeIN was calculated and age-standardized according to the European Standard population.

Results: Between 2000 and 2019 a total of 1113 PeIN cases were reported. The age-standardized incidence of PeIN was 1.40 per 100 000 men (95% confidence interval [CI] 1.32-1.49). An increase in incidence over time was seen, with a standardized incidence rate of 2.37 (95% CI 1.56-3.70) in 2019 compared to the baseline year, 2000. Surgical or topical treatments were given in 75.0% and 14.6% of cases, respectively. The complication rate was higher in laser surgery (12.1%, 7/58) compared to local surgery (4.6%, 16/348; P = 0.03) with an age-adjusted odds ratio (OR) of 2.82 (95% CI 1.10-7.19; P = 0.03). Local surgery was more common than laser surgery in the last 5 years compared to the first 5 years of the study period: OR 5.75 (95% CI 2.94-11.27). Treatments with imiquimod and topical 5-fluorouracil (5-FU) were more common than destructive methods such as photodynamic therapy, cryotherapy, curettage and electrocautery in the last 5 years compared to the first 5 years: OR 9.48 (95% CI 2.29-39.24).

Conclusions: A twofold increase in the age-standardized incidence of PeIN was seen in Sweden over 20 years. Complications were three times more common in laser surgery compared to local surgery. Changes in treatment showed an increase of treatment strategies such as local surgery and treatment with imiquimod and topical 5-FU over time.

Keywords: #PenileCancer; #uroonc; incidence; penile cancer; penile intraepithelial neoplasia; treatment.

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Conflict of interest statement

None declared.

Figures

Fig. 1
Fig. 1
Age‐standardized incidence rate of penile intraepithelial neoplasia per 100 000 men and year. [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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