Human papillomavirus (HPV) is a common sexually transmitted infection that is strongly associated with cervical cancer. A link to penile cancers has been suggested by case series. We sought to assess the strength of the association between HPV infection and penile cancer by meta-analysis.
A literature search to identify population-based studies evaluating the risk of HPV infection with penile cancer was conducted via PubMed, Google Scholar, and Web of Science databases through December 2020. Studies were included in the pooled analyses if they presented relative risk estimates (RR) comparing penile cancer cases to non-cases by HPV exposure status. They were stratified by (1) type of HPV, (2) test used to determine past HPV infection, and (3) the penile cancer type. Pooled analyses were conducted for stratum with at least two independent studies using fixed-effects and random-effects models.
Fourteen articles representing nine study populations fit the inclusion criteria and were included in the pooled analysis. Based on these studies, the pooled RRs for invasive penile cancer and seropositivity to HPV16 L1 is 2.9 (95% confidence interval (CI): 1.7, 5.0; N = 4 studies), seropositivity to HPV18 is 4.5 (95% CI: 1.3, 15.5; N = 2), and 8.7 for anogenital warts (95% CI: 5.1-14.8; N = 5). For the three studies reporting invasive and in-situ penile cancer, the risk was 7.6 for anogenital warts.
The pooled RRs indicate up to a 4.5-fold increased risk between seropositivity for HPV infection and invasive penile cancer. This is much lower than associations seen between HPV and cervical cancer.
Sexually transmitted diseases. 2022 Jan 25 [Epub ahead of print]
Collin J Catalfamo, Heidi E Brown, Leslie K Dennis
Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA.