Penis cancer usually affects older men 60-80 years and accounts for 0.4 to 0.8% of all cancers in men. In undeveloped countries, and especially in some African countries, the frequency increases and can reach up to 15%. This difference is mainly due to the fact that in these countries the local sanitary conditions are minimal to nonexistent.
Chronic irritation of sebum produced by the bacteria action appear to be the major causative agent of penile cancer.
Irritation, that becomes more pronounced in men with phimosis, is found in 25-75% of patients with penile cancer. The circumcision has been shown to protect against the risk of developing cancer.
For instance, penis cancer is rare to Jews where circumcision due to religion applies to everyone. A typical example is penile cancer frequency in India: in Jewish population circumcision is performed in newborns and have no penile cancer incidents; Muslims perform circumcision later in life and the incidence increases; the highest rate of penile cancer incidence appears in Christians who do not undergo circumcision.
Thus, apart from phimosis on its own the time that is performed is also relevant to penis cancer incidence. The later in life phimosis is performed, the less protection it offers against penile cancer.
Local cleaniness is also important to the development of the disease, and not circumcised. Untreated trauma and sexually transmitted diseases has been implicated as a predisposing factor in the development of cancer of the penis though considered a diagnostic method and not a causative factor.
In recent years, viruses consist a significant cause of penile cancer. Based on epidemiological research, patients’ wifes with penile cancer are 3 times more prone to suffer from cervix cancer than others. Viral particles’ finding in penile cancer biopsies, led to the conclusion that some virus strains are involved in the development of penile cancer of the penis, e.g. HPV 16.