Juan Chipollini1, Sharon Chaing2, Charles C Peyton3, Pranav Sharma4, Laura C Kidd2, Anna R Giuliano5, Peter A Johnstone6, Philippe E Spiess3. 1. Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL. Electronic address: juan.chipollini@moffitt.org. 2. Morsani College of Medicine, University of South Florida, Tampa, FL. 3. Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL. 4. Department of Urology, Texas Tech University Health Science Center, Lubbock, TX. 5. Center for Infection Research in Cancer, Moffitt Cancer Center, Tampa, FL. 6. Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL.
Abstract
BACKGROUND: We analyzed the trends in presentation of squamous cell carcinoma (SCC) of the penis and determined the socioeconomic predictors for locally advanced (cT3-cT4) disease in the United States. PATIENT AND METHODS: The National Cancer Database was queried for patients with clinically nonmetastatic penile SCC and staging available from 1998 to 2012. Temporal trends per tumor stage were evaluated, and a multivariable logistic regression model was used to identify predictors for advanced presentation during the study period. RESULTS: A total of 5767 patients with stage ≤ T1-T2 (n = 5423) and T3-T4 (n = 344) disease were identified. Increasing trends were noted in all stages of penile SCC with a greater proportion of advanced cases over time (P = .001). Significant predictors of advanced presentation were age > 55 years, the presence of comorbidities, and Medicaid or no insurance (P < .05 for all). CONCLUSION: More penile SCC is being detected in the United States. Our results have demonstrated older age, presence of comorbidities, and Medicaid or no insurance as potential barriers to early access of care in the male population. Understanding the current socioeconomic gaps could help guide targeted interventions in vulnerable populations.
BACKGROUND: We analyzed the trends in presentation of squamous cell carcinoma (SCC) of the penis and determined the socioeconomic predictors for locally advanced (cT3-cT4) disease in the United States. PATIENT AND METHODS: The National Cancer Database was queried for patients with clinically nonmetastatic penile SCC and staging available from 1998 to 2012. Temporal trends per tumor stage were evaluated, and a multivariable logistic regression model was used to identify predictors for advanced presentation during the study period. RESULTS: A total of 5767 patients with stage ≤ T1-T2 (n = 5423) and T3-T4 (n = 344) disease were identified. Increasing trends were noted in all stages of penile SCC with a greater proportion of advanced cases over time (P = .001). Significant predictors of advanced presentation were age > 55 years, the presence of comorbidities, and Medicaid or no insurance (P < .05 for all). CONCLUSION: More penile SCC is being detected in the United States. Our results have demonstrated older age, presence of comorbidities, and Medicaid or no insurance as potential barriers to early access of care in the male population. Understanding the current socioeconomic gaps could help guide targeted interventions in vulnerable populations.
Authors: Peter A S Johnstone; David Boulware; Rosa Djajadiningrat; Sarah Ottenhof; Andrea Necchi; Mario Catanzaro; Dingwei Ye; Yao Zhu; Nicola Nicolai; Simon Horenblas; Philippe E Spiess Journal: Eur Urol Focus Date: 2018-10-14