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.

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.

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.

Summary

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.