Penile Cancer in Cali, Colombia: 10 Years of Casuistry in a Tertiary Referral Center of a Middle-Income Country

  • Lina M. Rengifo Fifth year Medical Student, Faculty of Health, Universidad del Valle, Cali, Colombia
  • Maria del M. Herrera Fifth year Medical Student, Faculty of Health, Universidad del Valle, Cali, Colombia.
  • Angie L. Rincon-Jimenez Fifth year Medical Student, Faculty of Health, Universidad del Valle, Cali, Colombia.
  • Alberto J. Bermudez-Pupo MD, Urologist, Professor, Urology Department, Universidad del Valle, Hospital Universitario del Valle "Evaristo Garcia" ESE, Cali, Colombia
  • Francisco J. Bonilla-Escobar MD, MSc(c), Editor in Chief IJMS. Research Associate, Cisalva Institute, Universidad del Valle, Cali, Colombia.
Keywords: Penile Neoplasms, Circumcision, Male, Smoking, Developing Countries


Background: Penile cancer is a rare disease in Colombia; in Cali, it represents 0.7% of all cancers. Penile cancer has been associated with old age, bad hygiene, smoking and lack of circumcision. This study aimed to describe the sociodemographic and clinica  characteristics of patients with penile cancer who consulted to a tertiary referral hospital. Methods: A case series of all penile cance cases at a reference institution in Cali during 2001-2010. Socioeconomic, demographic and clinical features of patients were described, and bivariate analyses were carried out. Results: There were 46 penile cancer cases. The average age was 60 ± 16.9 years. The main reason for consultation was an exophytic mass on the penis (75.0%). The most common location was the glans (69.6%), and the more frequent histology type was the squamous cell carcinoma (95.7%). With regard to risk factors, 65.5% of the patients had history of smoking and90.9% did not have circumcision. Patients who underwent radical amputation had higher rates of positive nodes (55% vs. 13.5%, p=0.015) and ulcerative lesions (77.8% vs. 29.7%, p=0.018) than those who did not have the procedure done. Recurrence was associated with the presence of lymphadenopathy (p=0.02) and history of circumcision (p=0.015). Conclusion: Most of the patients with penile cancer found in this study had old age, history of tobacco use and lack of circumcision. Patients who presented with lymph node metastasis had to undergo more radical procedures and suffered a greater rate of recurrence compared with those without lymph node involvement. Robust studies to determine the risk factors among low-income populations are required.

Author Biography

Lina M. Rengifo, Fifth year Medical Student, Faculty of Health, Universidad del Valle, Cali, Colombia

Lina Rengifo is a fifth year medical student at Universidad del Valle and is an active member of the Scientific Medical Students Association of Universidad del Valle (ACEMVAL).


1. Curado MP, Edwards B, Shin HR, Storm H, Ferlay J, Heanue M, et al. Cancer Incidence in Five Continents. France: International Agency for Research on Cancer (IARC). World Health Organization; 2007p.
2. Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ. Cancer statistics, 2007. CA Cancer J Clin. 2007 Jan-Feb;57(1):43-66.
3. Parkin DM, Ferlay J, Curado MP, Bray F, Edwards B, Shin HR, et al. Fifty years of cancer incidence: CI5 I–IX. Int J Cancer. 2010 Dec 15;127(12):2918-27.
4. Velazquez EF, Cubilla AL. Penile squamous cell carcinoma: anatomic, pa¬thologic and viral studies in Paraguay (1993-2007). Anal Quant Cytol Histol. 2007 Aug;29(4):185-98.
5. Favorito LA, Nardi AC, Ronalsa M, Zequi SC, Sampaio FJ, Glina S. Epidemiolo¬gic study on penile cancer in Brazil. Int Braz J Urol. 2008 Sep-Oct;34(5):587-93.
6. Cubilla AL. The role of pathologic prognostic factors in squamous cell carcinoma of the penis. World J Urol. 2009 Apr;27(2):169-77.
7. Cubilla AL, Velazquez EF, Young RH. Epithelial lesions associated with in¬vasive penile squamous cell carcinoma: a pathologic study of 288 cases. Int J Surg Pathol. 2004 Oct;12(4):351-64.
8. Kayes O, Ahmed HU, Arya M, Minhas S. Molecular and genetic pathways in penile cancer. Lancet Oncol. 2007 May;8(5):420-9.
9. Gross G, Pfister H. Role of human papillomavirus in penile cancer, penile intraepithelial squamous cell neoplasias and in genital warts. Med Microbiol Immunol. 2004 Feb;193(1):35-44.
10. van Geel AN, den Bakker MA, Kirkels W, Horenblas S, Kroon BB, de Wilt JH, et al. Prognosis of primary mucosal penile melanoma: a series of 19 Dutch patients and 47 patients from the literature. Urology. 2007 Jul;70(1):143-7.
11. Fetsch JF, Davis Jr CJ, Miettinen M, Sesterhenn IA. Leiomyosarcoma of the penis: a clinicopathologic study of 14 cases with review of the litera¬ture and discussion of the differential diagnosis. Am J Surg Pathol. 2004 Jan;28(1):115-25.
12. Daling JR, Madeleine MM, Johnson LG, Schwartz SM, Shera KA, Wurs¬cher MA, et al. Penile cancer: importance of circumcision, human papillo¬mavirus and smoking in in situ and invasive disease. Int J Cancer. 2005 Sep 10;116(4):606-16.
13. Calmon MF, Tasso Mota M, Vassallo J, Rahal P. Penile carcinoma: risk fac¬tors and molecular alterations. ScientificWorldJournal. 2011 Feb 3;11:269-82.
14. Pow-Sang MR, Ferreira U, Pow-Sang JM, Nardi AC, Destefano V. Epide¬miology and natural history of penile cancer. Urology. 2010 Aug;76(2 Suppl 1):S2-6.
15. Madsen BS, van den Brule AJ, Jensen HL, Wohlfahrt J, Frisch M. Risk factors for squamous cell carcinoma of the penis—population-based ca¬se-control study in Denmark. Cancer Epidemiol Biomarkers Prev. 2008 Oct;17(10):2683-91.
16. Larke NL, Thomas SL, dos Santos Silva I, Weiss HA. Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control. 2011 Aug;22(8):1097-110.
17. Ramírez G, Bermúdez AJ. [Penile Carcinoma in the Universitary Hospital del Valle]. Urol Colomb. 2004 Aug;13(2):47-50.
18. von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS me¬dicine. 2007 Oct 16;4(10):e296.
19. Chaux A, Netto GJ, Rodríguez IM, Barreto JE, Oertell J, Ocampos S, et al. Epidemiologic profile, sexual history, pathologic features, and human papi¬llomavirus status of 103 patients with penile carcinoma. World J Urol. 2013 Aug;31(4):861-7.
20. Hernandez BY, Barnholtz-Sloan J, German RR, Giuliano A, Goodman MT, King JB, et al. Burden of invasive squamous cell carcinoma of the penis in the United States, 1998–2003. Cancer. 2008 Nov 15;113(10 Suppl):2883-91.
21. Bleeker MC, Hogewoning CJ, Voorhorst FJ, van den Brule AJ, Berkhof J, Hesselink AT, et al. HPV-associated flat penile lesions in men of a non-STD hospital population: less frequent and smaller in size than in male sexual partners of women with CIN. Int J Cancer. 2005 Jan 1;113(1):36-41.
22. de Bruijn RE, Heideman DA, Kenter GG, van Beurden M, van Tinteren H, Horenblas S. Patients with penile cancer and the risk of (pre) malignant cervical lesions in female partners: a retrospective cohort analysis. BJU Int. 2013 Nov;112(7):905-8.
23. Blair A, Zahm SH, Pearce NE, Heineman EF, Fraumeni JF Jr. Clues to can¬cer etiology from studies of farmers. Scand J Work Environ Health. 1992 Aug;18(4):209-15.
24. Dich J, Zahm SH, Hanberg A, Adami HO. Pesticides and cancer. Cancer Causes Control. 1997 May;8(3):420-43.
25. Blair A, Malker H, Cantor KP, Burmeister L, Wiklund K. Cancer among far¬mers. A review. Scand J Work Environ Health. 1985 Dec;11(6):397-407.
26. Barnholtz-Sloan JS, Maldonado JL, Pow-Sang J, Guiliano AR. Incidence trends in primary malignant penile cancer. Urologic Oncology: Seminars and Original Investigations; 2007: Elsevier; 2007. p. 361-7.
27. Pow-Sang MR, Benavente V, Pow-Sang JE, Morante C, Meza L, Baker M, et al. Cancer of the penis. Cancer control. 2002 Jul-Aug;9(4):305-14.
28. D’Hauwers K, Depuydt C, Bogers J, Noel J, Delvenne P, Marbaix E, et al. Hu¬man papillomavirus, lichen sclerosus and penile cancer: a study in Belgium. Vaccine. 2012;30(46):6573-7.
29. Backes DM, Kurman RJ, Pimenta JM, Smith JS. Systematic review of hu¬man papillomavirus prevalence in invasive penile cancer. Cancer Causes & Control. 2009;20(4):449-57.
30. Pettaway CA, Pagliaro L, Theodore C, Haas G. Treatment of visceral, unre¬sectable, or bulky/unresectable regional metastases of penile cancer. Urolo¬gy. 2010;76(2):S58-S65.
31. Guimarães GC, Rocha RM, Zequi SC, Cunha IW, Soares FA. Penile cancer: epidemiology and treatment. Current oncology reports. 2011;13(3):231-9.
32. Block SL, Nolan T, Sattler C, Barr E, Giacoletti KE, Marchant CD, et al. Comparison of the immunogenicity and reactogenicity of a prophylactic qua¬drivalent human papillomavirus (types 6, 11, 16, and 18) L1 virus-like particle vaccine in male and female adolescents and young adult women. Pediatrics. 2006;118(5):2135-45.
How to Cite
M. Rengifo, L., Herrera, M. del M., Rincon-Jimenez, A. L., Bermudez-Pupo, A. J., & Bonilla-Escobar, F. J. (2014). Penile Cancer in Cali, Colombia: 10 Years of Casuistry in a Tertiary Referral Center of a Middle-Income Country. International Journal of Medical Students, 2(3), 109-114.
Original Article