Disparities in Penile Cancer Incidence, Mortality, and Place of Death Trends From 1999 to 2020

Racial/ethnic disparities have been found in the incidence, treatment, and outcomes of penile cancer; however, there is a need for evaluation in recent years. We investigated penile cancer-specific mortality, incidence, and place of death trends in the United States between 1999 and 2020. Overall penile cancer-specific mortality and incidence increased, indicating a need for improvements in penile cancer treatment and screening. Introduction: Penile cancer is rare in the United States (US); however, disparities have been found in the incidence, treatment, and outcomes of penile cancer. There is a need for evaluation of recent trends in penile cancer mortality, incidence, and place of death across all demographics. Materials and Methods: Using the CDC WONDER database, penile cancer-specific mortality (PNCSM) trends in the US were evaluated from 1999 to 2020 by race/ethnicity, age group, census region, and place of death. Penile cancer incidence trends for the US from 1995 to 2019 were gathered from the NAACCR database. Average annual percent changes for mortality and incidence rates were determined using Joinpoint regression modeling. Univariable and multivariable logistic regression were used to evaluate independent predictors associated with place of death. Results: From 1999 to 2020, 5833 people died from penile cancer in the US. Overall PNCSM increased by 1.8% per year from 1999-2020 (95% CI, 1.3%, 2.2%). Non-Hispanic White patients and Hispanic patients had increasing PNCSM rates from 1999-2020 (2.1 [95% CI, 1.5%, 2.7%]; 1.9 [95% CI, 1.0%, 2.8%], respectively). From the place of death analysis, Hispanic patients were at higher odds of dying at home or hospice when compared to non-Hispanic White patients (adjusted odds ratio [aOR] = 1.19, P = .045). Age-adjusted incidence rates for all stages of penile cancer increased significantly from 1995-2016 (AAPC, 0.7% [95% CI, 0.4%, 1.0%]), driven by regional and distant penile cancer incidence rates (AAPC 1995-2019, regional: 2.0% [95% CI, 1.7%, 2.4%]; AAPC 19952019, distant: 2.5% [95% CI, 1.8%, 3.1%]). Conclusion: The increasing penile cancer-specific mortality and incidence rates indicate the need for further improvements in screening, diagnosis, and treatment. Widespread efforts across all demographics are needed to ensure early detection of the disease.