Penile cancer: is there an epidemiological role for smoking and sexual behaviour?

A retrospective study was carried out to determine whether penile cancer, like cervical cancer, was associated with smoking and sexual behaviour. Altogether 244 men with penile cancer and 232 matched controls completed a questionnaire by post or telephone. Data on marital state, socioeconomic group, occupation, history of phimosis and balanitis, sexual behaviour, and smoking were obtained. The results of statistical analyses confirmed that phimosis and balanitis were risk factors for penile cancer, but there was no epidemiological evidence for it being a sexually transmitted disease. Smoking was a risk factor with a dose-response relation and remained associated with penile cancer even after adjustment for confounding factors. Penile cancer is associated with smoking independently of phimosis; treatment of phimosis alone does not remove the risk caused by smoking.