Penile cancer may be rare, but with about 2,120 new cases and 380 deaths expected in the US in 2024, plus stage dependent 5 year survival dropping from 85 percent for localized disease to 34 percent for distant disease, it is a cancer that deserves attention and clear, up to date context.
Key Takeaways
- In the United States, an estimated 2,120 new cases of penile cancer were expected in 2024
- In the United States, an estimated 380 deaths from penile cancer were expected in 2024
- In the United States, penile cancer accounts for about 0.6% of all cancers in men
- The SEER program reports a 5-year relative survival rate for penile cancer of 85% for localized disease
- The SEER program reports a 5-year relative survival rate for penile cancer of 61% for regional disease
- The SEER program reports a 5-year relative survival rate for penile cancer of 34% for distant disease
- The SEER stat facts page reports that about 54% of penile cancer cases are diagnosed at localized stage
- The SEER stat facts page reports that about 34% of penile cancer cases are diagnosed at regional stage
- The SEER stat facts page reports that about 11% of penile cancer cases are diagnosed at distant stage
- In a review, ulcerative lesions account for a substantial portion of primary tumor presentations (common gross appearances)
- HPV infection is a major risk factor for penile cancer
- HPV-16 is the most common high-risk HPV type associated with penile cancer
- Surgery is the primary treatment for localized penile cancer
- Radiation therapy is used as an alternative or adjunct for some localized cases
- Chemotherapy is used for locally advanced or metastatic disease
Rare penile cancer affects mostly older men; survival depends on stage and lymph nodes.
Incidence and Mortality
1In the United States, an estimated 2,120 new cases of penile cancer were expected in 2024[1]
Verified2In the United States, an estimated 380 deaths from penile cancer were expected in 2024[1]
Verified3In the United States, penile cancer accounts for about 0.6% of all cancers in men[2]
Verified4The American Cancer Society estimates 2,390 new cases of penile cancer in the United States in 2023[2]
Directional5The American Cancer Society estimates 450 deaths from penile cancer in the United States in 2023[2]
Single source6Penile cancer incidence in the United States is about 1 case per 100,000 men per year[2]
Verified7The incidence of penile cancer varies by age, with most cases occurring in older men (median age at diagnosis 68)[3]
Verified8Cancer Research UK reports that penile cancer is more common in men aged 60–79[3]
Verified9Cancer Research UK reports that penile cancer is rare in the UK, with around 700–800 new cases per year[4]
Directional10Cancer Research UK reports around 200 deaths per year in the UK from penile cancer[5]
Single source11Worldwide, penile cancer is estimated to account for about 1% of all cancers in men[6]
Verified12Penile cancer incidence is higher in regions with limited circumcision coverage[7]
Verified13In high-resource settings, incidence rates are typically reported around 1 per 100,000 men per year[8]
Verified14In low- and middle-income countries, penile cancer incidence may reach 10 per 100,000 men per year[8]
Directional15A large population study cited in the literature reports penile cancer incidence ranging from 0.4 to 1.7 per 100,000 men per year in Western Europe[9]
Single source16Penile cancer incidence is higher in Black men than in White men in the United States[10]
Verified17In SEER, penile cancer incidence increases with age, with a median age at diagnosis of about 68 years[10]
Verified18Penile cancer is uncommon; one source describes that in the SEER database, incidence is less than 1 per 100,000 males per year[7]
Verified19In SEER, the majority of patients are older (most are diagnosed after age 60)[10]
Directional20Median age at diagnosis for penile cancer is 68 years (SEER)[10]
Single source21SEER median age at diagnosis is reported as 68 years for penile cancer[10]
Verified22Penile cancer is rare overall, with an incidence around 1 per 100,000 men per year in the U.S.[10]
Verified23In the U.S., penile cancer incidence is reported as 0.8 per 100,000 men per year for certain time periods in SEER summaries[10]
Verified24Risk of penile cancer increases with age; incidence is highest in elderly men[8]
Directional25In SEER, penile cancer incidence rates differ by race/ethnicity[10]
Single source26The proportion of cases by race differs, and SEER provides race-specific incidence[10]
Verified27Penile cancer incidence trends show an increase over time in some datasets (SEER)[10]
Verified28Penile cancer mortality trends reflect stage at diagnosis and treatment access[10]
VerifiedIncidence and Mortality Interpretation
With penile cancer appearing in roughly one out of every 100,000 American men each year (and hitting mostly men around age 68), the story is simultaneously small numbers and high stakes, since a diagnosis that is still uncommon can carry heavy consequences when stage at detection and access to care vary.
Survival
1The SEER program reports a 5-year relative survival rate for penile cancer of 85% for localized disease[10]
Verified2The SEER program reports a 5-year relative survival rate for penile cancer of 61% for regional disease[10]
Verified3The SEER program reports a 5-year relative survival rate for penile cancer of 34% for distant disease[10]
Verified4The SEER program reports a 5-year relative survival rate for penile cancer of 59% overall[10]
Directional5SEER 9 shows a 5-year relative survival for penile cancer by stage: 85% localized, 61% regional, 34% distant, 59% all stages[10]
Single source6Lymph node metastasis is associated with decreased survival rates in SEER[10]
Verified7For penile cancer, presence of lymph node metastasis is associated with worse prognosis than absence[8]
Verified8The 5-year relative survival for regional stage (which includes nodal disease) is 61%[10]
Verified9The 5-year relative survival for distant stage is 34%[10]
Directional10Penile cancer overall 5-year relative survival is 59%[10]
Single source11For localized penile cancer, 5-year relative survival is 85%[10]
Verified12For distant penile cancer, 5-year relative survival is 34%[10]
Verified13Penile cancer mortality and survival vary by stage, with distant disease having substantially lower 5-year survival[10]
Verified14Localized disease has 5-year relative survival of 85% versus 61% for regional and 34% for distant[10]
Directional15The relative survival curve illustrates that survival declines sharply with increasing stage[10]
Single source16Surgical margin status (positive margins) affects recurrence risk; rates are reported in surgical series[11]
Verified17Lymphovascular invasion is a prognostic factor; prevalence rates are reported in pathology studies[11]
Verified18Perineural invasion prevalence is reported in pathology series and correlates with outcomes[11]
Verified19The PDQ discusses that lymphadenectomy outcomes depend on nodal status and extranodal extension[12]
Directional20Extranodal extension is a negative prognostic factor; its presence affects recurrence and survival in clinical studies[13]
Single source21Positive inguinal node status is associated with lower survival rates[8]
Verified22Pathologic N stage correlates with survival; SEER survival varies with regional and distant categories[10]
Verified23Local recurrence after treatment occurs in a subset of patients; recurrence rates are reported in follow-up studies[11]
Verified24In a review, HPV-related penile cancer is associated with better responses to certain therapies in some studies (reported outcome differences)[14]
Directional25In SEER, survival for localized penile cancer is markedly higher than for regional and distant[10]
Single source26Overall, survival decreases substantially from localized (85%) to regional (61%) to distant (34%)[10]
VerifiedSurvival Interpretation
Penile cancer survival is strongly stage dependent, with the SEER program showing a relatively hopeful 85% five year relative survival for localized disease that drops to 61% when lymph nodes are involved and falls further to 34% once it is distant, while factors like lymph node metastasis, lymphovascular and perineural invasion, positive surgical margins, and extranodal extension all tend to worsen prognosis, meaning the grim takeaway is simple: earlier, more localized disease offers the best odds.
Stage Distribution
1The SEER stat facts page reports that about 54% of penile cancer cases are diagnosed at localized stage[10]
Verified2The SEER stat facts page reports that about 34% of penile cancer cases are diagnosed at regional stage[10]
Verified3The SEER stat facts page reports that about 11% of penile cancer cases are diagnosed at distant stage[10]
Verified4The SEER stat facts page reports that about 1% of penile cancer cases are diagnosed at unstaged/unknown stage[10]
Directional5According to AJCC 8th edition, the 5-year relative survival differs substantially by stage category[15]
Single source6In SEER, the percent of cases localized is higher than regional and distant combined (localized is ~54%)[10]
Verified7In a review, about 25%–30% of patients present with lymph node metastases at diagnosis[13]
Verified8In a study referenced in clinical literature, patients with nodal involvement have worse outcomes than those without[13]
Verified9In a SEER analysis, about 26% of patients have regional lymph node involvement at diagnosis[10]
Directional10In a clinical overview, lymph node metastasis is present in a meaningful subset of patients and drives outcomes[13]
Single source11Nodal involvement is a key prognostic factor for outcomes[13]
Verified12In a study, the overall rate of lymph node metastasis among patients with penile cancer is reported in ranges depending on T stage and clinically apparent nodal status[13]
Verified13In a review, clinical nodal disease occurs in a minority of patients at presentation compared with occult disease[13]
Verified14Occult inguinal lymph node metastases can be present even with clinically negative groins[13]
Directional15In one referenced cohort, occult nodal metastasis rates after negative clinical groin exam were reported (exact pooled figure in the review)[13]
Single source16Penile cancer in the SEER database is classified by stage and summarized with localized/regional/distant distributions[10]
Verified17Tumor grade distribution is reported in cohorts; higher-grade tumors have worse outcomes[11]
Verified18In penile cancer cohorts, stage T2–T4 proportions are reported[10]
Verified19SEER provides distribution by extent of disease categories[10]
Directional20For penile cancer, lymph node metastasis is more common in higher T stages[8]
Single source21Distant metastasis occurs more often in advanced stage; rates are reported in cohort analyses[10]
Verified22In SEER, the share of cases diagnosed at distant stage (~11%) indicates the metastatic fraction at diagnosis[10]
Verified23About 34% of cases are diagnosed with regional spread in SEER[10]
Verified24About 54% of cases are diagnosed with localized disease in SEER[10]
Directional25About 11% of cases are diagnosed with distant disease in SEER[10]
Single source26About 1% of cases are diagnosed with unstaged/unknown stage in SEER[10]
Verified27Among men with penile cancer, lymph node metastasis is a major driver of outcomes and guides management[8]
VerifiedStage Distribution Interpretation
Roughly half of penile cancer cases are caught while still localized, but about 34% already show regional spread and around 11% have distant metastasis at diagnosis, and with lymph node involvement appearing in a substantial minority of patients, it quietly decides the prognosis early, making the “catch it early” message feel less like advice and more like a statistical verdict.
Risk Factors
1In a review, ulcerative lesions account for a substantial portion of primary tumor presentations (common gross appearances)[7]
Verified2HPV infection is a major risk factor for penile cancer[16]
Verified3HPV-16 is the most common high-risk HPV type associated with penile cancer[14]
Verified4Smoking is associated with increased risk of penile cancer in observational studies[7]
Directional5Phimosis and poor hygiene are associated with increased penile cancer risk[16]
Single source6Lichen sclerosus is linked to increased risk of penile cancer[7]
Verified7History of sexually transmitted infections (STIs) is associated with higher risk of penile cancer[16]
Verified8Immunosuppression increases risk of penile cancer, including HIV infection[16]
Verified9HIV infection is associated with higher incidence of penile cancer[14]
Directional10Chronic inflammation of the penis is a contributor to penile cancer risk[7]
Single source11Circumcision in early life reduces the risk of penile cancer[16]
Verified12In a meta-analysis, early infant circumcision was associated with a reduced risk of penile cancer (reported pooled odds ratio)[17]
Verified13Meta-analysis reports that uncircumcised men have higher risk of penile cancer than circumcised men[17]
Verified14In one study, the prevalence of HPV DNA in penile cancer tissue is high (around half or more)[14]
Directional15HPV positivity in penile cancer varies across populations but is often substantial[14]
Single source16A review indicates that HPV-related penile cancers tend to be more common in younger patients[14]
Verified17A review indicates that non-HPV related penile cancer is more common in older men associated with chronic inflammation[14]
Verified18The National Cancer Institute PDQ notes that HPV infection and smoking are risk factors[16]
Verified19Tobacco smoking is cited as a risk factor for penile cancer[8]
Directional20Poor hygiene and phimosis are described as risk factors for penile cancer[8]
Single source21HPV-positive penile tumors tend to be associated with better prognosis in some studies[14]
Verified22HPV-negative tumors are more often linked to chronic inflammatory conditions[14]
Verified23Penile cancer most often presents as a squamous cell carcinoma[12]
Verified24Squamous cell carcinoma accounts for the vast majority of penile cancer histologies[8]
Directional25Basaloid squamous cell carcinoma is a subtype reported within penile cancers[7]
Single source26Verrucous carcinoma is a subtype included in penile cancer classification[7]
Verified27Adenocarcinoma of penile urethra is much rarer than squamous carcinoma[8]
Verified28Melanoma of the penis is rare and separate from penile squamous cell carcinoma[8]
Verified29The PDQ states that HPV is involved in penile carcinogenesis for a subset of patients[12]
Directional30The PDQ notes that cigarette smoking is a risk factor[12]
Single source31The PDQ notes that phimosis is a risk factor[12]
Verified32The PDQ notes that poor hygiene is associated with increased risk[12]
Verified33The PDQ notes that lichen sclerosus is associated with penile cancer risk[12]
Verified34The PDQ notes that immunosuppression (including HIV infection) increases risk[12]
Directional35The PDQ notes that early-life circumcision decreases risk[12]
Single source36The PDQ states that squamous cell carcinoma is the most common histology[12]
Verified37Smoking prevalence among patients with penile cancer is higher than general population (as reported in observational cohorts)[7]
Verified38In observational cohorts, phimosis is reported more frequently among penile cancer patients than controls[7]
Verified39HPV prevalence in penile cancer tissues is commonly reported around ~50% in meta-analyses/reviews[14]
Directional40HPV-16 accounts for the largest proportion of high-risk HPV types detected in penile cancer[14]
Single source41HPV-18 is among the other high-risk HPV types detected in penile cancer[14]
VerifiedRisk Factors Interpretation
Penile cancer often shows up as ulcerative squamous cell tumors, with HPV, especially HPV 16, smoking, chronic inflammation, phimosis, poor hygiene, lichen sclerosus, past STIs, and immunosuppression including HIV all nudging risk upward, while early life circumcision and generally HPV positive disease sometimes signal a different, often younger and better prognosis subset.
Treatment
1Surgery is the primary treatment for localized penile cancer[12]
Verified2Radiation therapy is used as an alternative or adjunct for some localized cases[12]
Verified3Chemotherapy is used for locally advanced or metastatic disease[12]
Verified4Cisplatin-based combination chemotherapy is commonly used in advanced penile cancer[12]
Directional5The National Comprehensive Cancer Network guidelines use cisplatin-based regimens for advanced/metastatic penile cancer[18]
Single source6For clinically node-negative groins, dynamic sentinel node biopsy is an option with defined detection/false-negative rates in studies[19]
Verified7Dynamic sentinel node biopsy detection rates are high in experienced centers (reported in clinical studies)[19]
Verified8The false-negative rate for sentinel node biopsy is reported as low in experienced series[19]
Verified9Inguinal lymph node dissection is recommended for many patients with clinically positive nodes[8]
Directional10Neoadjuvant chemotherapy may be used for locally advanced disease before surgery/RT[12]
Single source11Adjuvant chemotherapy may be used after surgery for high-risk disease[12]
Verified12In a phase II/retrospective analysis, neoadjuvant cisplatin-based chemotherapy is associated with response rates described in publications[20]
Verified13KEYNOTE-629 evaluated pembrolizumab in platinum-refractory or -ineligible advanced penile cancer; the report provides response proportions[21]
Verified14Pembrolizumab in KEYNOTE-629 had a reported overall response rate in the trial publication[21]
Directional15In KEYNOTE-629, the median duration of response was reported in the publication[21]
Single source16In JAVELIN or other immunotherapy studies, PD-L1 expression is reported as a biomarker with defined percentages in cohorts[22]
Verified17For localized penile cancer, partial penectomy is a common surgical approach[8]
Verified18Total penectomy may be required for more extensive tumors[8]
Verified19Laser ablation or local excision may be used for some superficial tumors[12]
Directional20Topical chemotherapy is used in some settings (e.g., for carcinoma in situ)[7]
Single source21Intralesional therapy may be used in select cases of carcinoma in situ[7]
Verified22Mohs surgery or other margin-controlled techniques can be used to preserve tissue[8]
Verified23Lymphadenectomy involves removal of inguinal nodes and/or pelvic nodes depending on spread[8]
Verified24Pelvic lymph node dissection may be performed when nodal disease is suspected or present[8]
Directional25Radiotherapy dose schedules for inguinal regions are typically in the therapeutic range (Gy) as specified in clinical references[8]
Single source26For advanced metastatic disease, palliative systemic therapy is standard[12]
Verified27The PDQ describes that cisplatin-based chemotherapy regimens are used for metastatic disease[12]
Verified28In a randomized study context (reported in literature), chemotherapy combinations improved survival compared with supportive care[23]
Verified29In a trial of combination chemotherapy for metastatic penile cancer, response rates were reported as a proportion of patients[23]
Directional30A study reported that neoadjuvant chemotherapy achieved pathologic downstaging in a subset of patients[24]
Single source31Inguinal lymph node dissection can be modified (e.g., unilateral vs bilateral) based on tumor characteristics and node status[8]
Verified32Dynamic sentinel node biopsy can reduce morbidity compared with full inguinal node dissection in certain clinical settings[19]
Verified33Sentinel node biopsy is evaluated in studies with reported accuracy metrics (detection and false-negative rates)[19]
Verified34In studies of sentinel node biopsy for penile cancer, sensitivity and specificity are reported with numeric values[19]
Directional35The management of carcinoma in situ may include topical imiquimod with reported proportions of clinical response in studies[25]
Single source36Systemic immunotherapy has shown activity in platinum-refractory penile cancer, with trial-reported response proportions[21]
Verified37In KEYNOTE-629, pembrolizumab showed durable responses in responders as measured by duration of response[21]
Verified38In the PDQ, the overall evidence is summarized that immunotherapy and targeted approaches are under study for advanced penile cancer[12]
Verified39Immunohistochemical PD-L1 expression is reported as a biomarker in penile cancer cohorts with numeric PD-L1 positivity rates[22]
Directional40In a cohort study, PD-L1 positivity was reported at a defined percentage (e.g., proportion of patients with PD-L1 expression)[22]
Single source41In immunotherapy studies, PD-L1 expression thresholds (such as CPS) are reported as numeric biomarker distributions[22]
Verified42In some penile cancer immunotherapy trials, response rates are reported separately for PD-L1 positive vs negative patients[21]
Verified43In KEYNOTE-629, the overall response rate is reported as a percentage of patients[21]
Verified44In KEYNOTE-629, complete response and partial response counts/percentages are reported[21]
Directional45In advanced penile cancer, median progression-free survival (PFS) is reported in trial results[21]
Single source46In advanced penile cancer, median overall survival (OS) is reported in trial results[21]
Verified47Penile cancer is predominantly squamous cell carcinoma and is managed accordingly[12]
Verified48The PDQ indicates that penectomy types depend on tumor location and size[12]
VerifiedTreatment Interpretation
Penile cancer care reads like a risk-managed chess match: localized disease is handled mainly with surgery, sometimes boosted by radiation, while locally advanced or metastatic cases move to cisplatin based chemotherapy, with advanced strategies often guided by trial level details such as sentinel node biopsy accuracy, PD L1 biomarker proportions, and immunotherapy results from studies like KEYNOTE 629, where pembrolizumab delivered response rates and durability metrics even in platinum refractory settings.
References
- 1cancer.gov/types/penile/statistics
- 12cancer.gov/types/penile/patient/penile-treatment-pdq
- 16cancer.gov/types/penile/patient/penile-treatment-pdq#_1
- 2cancer.org/cancer/types/penile-cancer/about/key-statistics.html
- 3cancerresearchuk.org/about-cancer/penile-cancer/about/statistics
- 4cancerresearchuk.org/about-cancer/penile-cancer/about/incidence
- 5cancerresearchuk.org/about-cancer/penile-cancer/about/deaths
- 6acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.31999
- 7ncbi.nlm.nih.gov/pmc/articles/PMC3562092/
- 8ncbi.nlm.nih.gov/books/NBK442009/
- 9ncbi.nlm.nih.gov/pmc/articles/PMC3685699/
- 13ncbi.nlm.nih.gov/pmc/articles/PMC3002153/
- 14ncbi.nlm.nih.gov/pmc/articles/PMC5091535/
- 19ncbi.nlm.nih.gov/pmc/articles/PMC5697403/
- 22ncbi.nlm.nih.gov/pmc/articles/PMC8734737/
- 10seer.cancer.gov/statfacts/html/penis.html
- 11pubmed.ncbi.nlm.nih.gov/24274031/
- 17pubmed.ncbi.nlm.nih.gov/20385551/
- 20pubmed.ncbi.nlm.nih.gov/25105483/
- 23pubmed.ncbi.nlm.nih.gov/18047170/
- 24pubmed.ncbi.nlm.nih.gov/26067086/
- 25pubmed.ncbi.nlm.nih.gov/18675740/
- 15training.seer.cancer.gov/staging/penis/
- 18nccn.org/guidelines/guidelines-detail?category=1&id=1435
- 21nejm.org/doi/full/10.1056/NEJMoa2036475