To analyse incidence, treatment strategies and complications of Penile Intraepithelial Neoplasia (PeIN) in Sweden over a period of 20 years.
Data on PeIN from the Swedish National Penile Cancer Register was analysed regarding treatment in relation to age, size of the PeIN lesion, localisation of the PeIN lesion and complications using Chi-square tests and logistic regression. Incidence of PeIN was calculated and age-standardized according to the European Standard population.
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 (SIR) of 2.37 (95 % CI 1.56-3.70) in 2019 compared to baseline year 2000. Surgical or topical treatments were given in 75.0% and 14.6% of cases respectively. Complication rate were 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 five years compared to the first five 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 five years compared to the first five years OR 9.48 (95% CI 2.29 - 39.24).
A twofold increase of 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.
BJU international. 2022 Jan 19 [Epub ahead of print]
S Kristiansen, C Torbrand, Å Svensson, O Forslund, C Bjartling
Department of Dermatology and Venereology, Skane University Hospital, Lund University, Malmö, Sweden., Department of Urology, Helsingborg Hospital, Helsingborg, Sweden. Institution of Translational Medicine, Lund University, Malmö, Sweden., Laboratory Medicine, Department of Medical Microbiology, Lund University, Lund, Sweden., Department of Obstetrics and Gynaecology, Skane University Hospital, Lund University, Malmö, Sweden.