How HPV Is Associated With Penile Cancer

Not all penile cancers are caused by human papillomavirus (HPV), and these cancers remain relatively rare in the developed world. However, research suggests roughly 60% of all penile cancers are linked to HPV, particularly the HPV-16 strain.

This article looks at cancer of the penis, why there may be a link to the sexually transmitted HPV virus, and how to protect yourself and reduce your risk of penile cancer.

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What Is Penile Cancer?

Penile cancer is rare in the United States. It accounts for less than 1% of all cancers in males in the U.S., with roughly 2,000 new cases and 470 deaths yearly. When it's diagnosed and treated early, penile cancer has a five-year survival rate of over 80%.

There are seven kinds of penile cancer, and squamous cell carcinomas account for about 95% of all cases.

Penile cancers usually begin with lesions, or sores, on the head or shaft of the penis. The lesions can be red bumps that look more like a rash, or the skin may be crusty. It's common for smelly fluid to leak from the sores, and you may have pain when urinating.

The HPV Connection

There are more than 200 types or "strains" of HPV, each identified with a number. Of the 15 HPV strains that can cause cancer, seven are associated with penile cancer: HPV 16, 18, 31, 33, 45, 56, and 65.

The HPV 16 is most often associated with penile cancer, followed by HPV 18. These two HPV strains account for at least a third of all squamous-cell penile cancers, by far the most common type.

A 2008 study in Denmark found a link between penile cancer and heterosexual oral sex. Oral sex is associated with HPV infection, and oral cancer is indirectly caused by HPV.

It remains unclear whether HPV-related penile cancers are more invasive than non-viral cancers. Some studies have shown that HPV-related cancers may be more likely to spread to the lymph nodes, which is generally associated with worse outcomes. Other studies, however, have found the opposite result and concluded that HPV-related tumors are less aggressive and respond better to treatment.


There is still much to know, but years of research have already found evidence linking HPV infection to some cancers, including cancers of the penis. Because HPV is a sexually transmitted infection, and its high-risk strains may lead to cancer, it's important to prevent it. A vaccine is available to help protect from the virus.

Reducing Your Risk

There are two basic ways to reduce your risk for HPV-related penile cancers. The first is to consistently practice safe sex. Using condoms during sexual activity—including vaginal, anal, and oral—reduces the likelihood you'll be exposed to HPV.

The second thing you can do is get the HPV vaccine. The best time to get the HPV vaccine is before you become sexually active. But the vaccine can also protect against HPV after you've already had sex.

Other Risk Factors

Penis cancer is also associated with other sexual risk factors and men's health conditions, such as phimosis and balanitis. Smoking and HIV infection are additional risk factors.


Penile cancer is rare, and there is a link to HPV. There are seven different kinds of penile cancer, and there are also many different strains of HPV. Only some of them, including HPV16, have been linked to cancer of the penis.

Penile cancer has a good general survival rate but, as with other cancers, it depends on the type. how long it's been developing, your age, and your health conditions. Your doctor will help you navigate what penile cancer can mean for your health and overall quality of life.

A Word From Verywell

It's rare for a male in North America or Europe to have penile cancer. The diagnosis is far more common in parts of Asia, Africa, and South America, with the Brazilian state of Maranhão having one of the highest rates in the world.

That said, the risk may be higher if you have a sexually transmitted HPV infection. If you're experiencing painful sores or other symptoms, be sure to tell your doctor right away so you can find out why.

9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Viens LJ, Henley SJ, Watson M, et al. Human papillomavirus-associated cancers - United States, 2008-2012. MMWR Morb Mortal Wkly Rep. 2016;65(26):661-666. doi:10.15585/mmwr.mm6526a1

  2. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin. 2022;72(1):7-33. doi:10.3322/caac.21708

  3. American Cancer Society. Survival rates for penile cancer.

  4. Hakenberg OW, Dräger DL, Erbersdobler A, Naumann CM, Jünemann KP, Protzel C. The diagnosis and treatment of penile cancer. Dtsch Arztebl Int. 2018;115(39):646-652. doi:10.3238/arztebl.2018.0646

  5. Kidd LC, Chaing S, Chipollini J, Giuliano AR, Spiess PE, Sharma P. Relationship between human papillomavirus and penile cancer-implications for prevention and treatment. Transl Androl Urol. 2017;6(5):791-802. doi:10.21037/tau.2017.06.27

  6. Iorga L, Dragos Marcu R, Cristina Diaconu C, et al. Penile carcinoma and HPV infection (Review). Exp Ther Med. 2020;20(1):91-96. doi:10.3892/etm.2019.8181

  7. Madsen BS, van den Brule AJC, Jensen HL, Wohlfahrt J, Frisch M. Risk factors for squamous cell carcinoma of the penis--population-based case-control study in Denmark. Cancer Epidemiol Biomarkers Prev. 2008;17(10):2683-2691. doi:10.1158/1055-9965.EPI-08-0456

  8. Timbang MR, Sim MW, Bewley AF, Farwell DG, Mantravadi A, Moore MG. HPV-related oropharyngeal cancer: a review on burden of the disease and opportunities for prevention and early detection. Hum Vaccin Immunother. 2019;15(7-8):1920-1928. doi:10.1080/21645515.2019.1600985

  9. Douglawi A, Masterson TA. Updates on the epidemiology and risk factors for penile cancer. Transl Androl Urol. 2017;6(5):785-790. doi:10.21037/tau.2017.05.19

Additional Reading
  • Madsen BS et al. (2008) "Risk factors for squamous cell carcinoma of the penis-population-based case-control study in Denmark." Cancer Epidemiology Biomarkers and Prevention 17:2683-2691.
  • Mentrikoski MJ, Stelow EB, Culp S, Frierson HF Jr, Cathro HP. Histologic and immunohistochemical assessment of penile carcinomas in a North American population. Am J Surg Pathol. 2014 Oct;38(10):1340-8.
  • Sanchez DF, Cañete S, Fernández-Nestosa MJ, Lezcano C, Rodríguez I, Barreto J, Alvarado-Cabrero I, Cubilla AL. HPV- and non-HPV-related subtypes of penile squamous cell carcinoma (SCC): Morphological features and differential diagnosis  according to the new WHO classification (2015). Semin Diagn Pathol. 2015 May;32(3):198-221. doi: 10.1053/j.semdp.2014.12.018.
  • Steinestel J, Al Ghazal A, Arndt A, Schnoeller TJ, Schrader AJ, Moeller P, Steinestel K. The role of histologic subtype, p16(INK4a) expression, and presence of human papillomavirus DNA in penile squamous cell carcinoma. BMC Cancer. 2015 Apr 3;15:220. doi: 10.1186/s12885-015-1268-z.
  • Vogt SL, Gravitt PE, Martinson NA, Hoffmann J, D'Souza G. Concordant Oral-Genital HPV Infection in South Africa Couples: Evidence for Transmission. Front Oncol. 2013 Dec 12;3:303. doi: 10.3389/fonc.2013.00303.

By Elizabeth Boskey, PhD
Elizabeth Boskey, PhD, MPH, CHES, is a social worker, adjunct lecturer, and expert writer in the field of sexually transmitted diseases.