Can penile cancer be prevented?
The large variations in penile cancer rates throughout the world strongly suggest that many penile cancers can be prevented. The best way to reduce the risk of penile cancer is to avoid known risk factors whenever possible (see “What are the risk factors for penile cancer?”). But some men with penile cancer have no known avoidable risk factors, so it’s not possible to prevent this disease completely.
In the past, circumcision (removing the foreskin on the penis) has been suggested as a way to lower penile cancer risk. This was based on studies that reported much lower penile cancer rates among circumcised men than among uncircumcised men. But in some studies, the protective effect of circumcision was no longer seen after factors like smegma and phimosis were taken into account.
In the United States, the risk of penile cancer is low even among uncircumcised men. Men who wish to lower their risk of penile cancer can do so in other ways, such as by avoiding human papilloma virus (HPV) and human immunodeficiency virus (HIV) infection and by not smoking. Men who aren’t circumcised can also lower their risk of penile cancer by practicing good genital hygiene. Although infant circumcision can lower the risk of penile cancer, based on the low risk of this cancer in the US, it would take over 900 circumcisions to prevent one case of penile cancer in this country.
Perhaps the most important factor in preventing penile cancer in uncircumcised men is good genital hygiene. Uncircumcised men need to pull back (retract) the foreskin and clean the entire penis. If the foreskin is constricted and difficult to retract (a condition called phimosis), a doctor may be able to prescribe a cream or ointment that can make it easier to do so. If this doesn’t work the doctor may cut the skin of the foreskin in a procedure called a dorsal slit to make retraction easier.
Avoiding HPV infection
All men should do what they can to avoid being infected with HPV. Along with lowering penile cancer risk, this could have an even bigger impact on the risk of cervical cancer in their female partners.
The main factors influencing the risk of genital HPV infection in men are circumcision and the number of sexual partners. Men who are circumcised have a lower chance of becoming and staying infected with HPV. The reasons for this are unclear. It may be that after circumcision the skin on the glans (tip of the penis) goes through changes that make it more resistant to HPV infection. Another theory is that the surface of the foreskin (which is removed by circumcision) is more easily infected by HPV. Still, circumcision does not protect completely against HPV infection. Men who are circumcised can still get HPV and pass it on to their partners. The risk of being infected with HPV is also strongly linked to having many sexual partners (over a man’s lifetime).
Condoms provide some protection against HPV, but they don’t prevent infection completely. Men who use condoms regularly are less likely to be infected with HPV and pass it on to their female partners. Condoms can’t protect completely because they don't cover every possible HPV-infected area of the body, such as the skin on the genital or anal area. Still, condoms do provide some protection against HPV, and they also protect against HIV and some other sexually transmitted infections.
A man can have an HPV infection for years without any symptoms, so the absence of visible warts can’t be used to tell if someone has HPV. Even when someone doesn’t have warts (or any other symptom), he (or she) can still be infected with HPV and pass the virus to somebody else.
Vaccines can help protect against certain HPV infections. All of them protect against infection with HPV subtypes 16 and 18. Some can also protect against infections with other HPV subtypes, including some types that cause anal and genital warts. All of the vaccines available in the US are approved for use in females, but only Gardasil® and Gardasil 9® are approved for use in males.
Although we know that these vaccines can help protect against infection with HPV, so far, they have not been studied to see if they lower the risk of penile cancer.
HPV vaccines work best if given before a person starts having sex (and is exposed to HPV). Giving the vaccine when they are young helps ensure that the person getting the vaccine has not yet been exposed to HPV and so is more likely to benefit.
The Advisory Committee on Immunization Practices (ACIP), part of the US Centers for Disease Control and Prevention (CDC), recommends that either of the Gardasil vaccines be given routinely to males aged 11 or 12 years. ACIP also recommends that the vaccine be given to males aged 13 through 21 years who haven’t been vaccinated previously or who have not completed the 3-dose series. Men aged 22 through 26 years may also be vaccinated. The vaccine is not recommended for older men because it’s more likely they would have already been infected with HPV at some point.
The hope is that HPV vaccines may eventually help reduce the risk of all cancers linked to HPV, including penile cancers.
For more on vaccines against HPV, see HPV Vaccines.
Smoking also increases penile cancer risk, so not smoking might lower that risk. Quitting smoking or never starting in the first place is a good way to reduce your risk of many diseases, including penile cancer.
Last Medical Review: 03/30/2015
Last Revised: 04/20/2015