Epidemiologia e fatores de risco para câncer de pênis no estado da Paraíba

Abstract

Introduction: Penile cancer is a rare disease in developed countries and a reality in underdeveloped countries. Few publications on penile cancer, its epidemiology and risk factors are available. Brazil has one of the highest incidence rates in the world and mortality rates are increasing. Previous studies associated disesase with phimosis, smoking, sexual promiscuity and low hygiene conditions. Objective: The present study aimed on evaluation of socioeconomic factors such as, life and sexual habits, possible risk factors and histopathological presentation of patients with penile cancer. Methods: A retrospective study was carried out with data from patients attending in two referral hospitals in Paraíba - Brazil between 2012 and 2017. The statistical survey was performed with the help of SPSS software (IBM Company; version17) .Referring to resolution 466/2012, the study was approved by the ethics committee of both hospitals. Results: A total of 103 patients with penile cancer was analyzed. Highest incidence was identified in the metropolitan areas of João Pessoa and Campina Grande. Of 103 patients, 46,4% were between 50 and 69 years old. Futhermore, most of the patient's were farmers (69,9%), married (81,5%), had a mixed ethical background (78,1%), catholics (92,2%), had incomplete elementary school or were illiterate (54,7 and 40%) and received less than two minimum wages as income (93,8%). Fimose, smoking, alcoholism and use of pesticides (68,9%, 58,8%, 73,1%, 52,6%),were present in a greater percentage of patients, as a multiplicity of plots (56,2%).Squamous cell carcinoma was present in 96.8% cases, 64% were moderately differentiated and 70.3% of the cases were suggestive of human papillomavirus-HPV. Conclusions: The study designed the epidemiological profile of penile cancer in the state of Paraíba until then not described and found possible new risk factors suspected for the disease. The high frequency of risk factors such as phimosis, smoking, HPV and multiplicity of partners confirm the evidence already consolidated in the literature, but we also found a high frequency of patients who used pesticides and alcohol, which are risk factors that are still poorly evaluated and that may be associated with the disease. The high number of farm patients reinforces the possible involvement of pesticides with the origin of the disease. Public policies that address the improvement of the education level of the population, guidance on genital hygiene and sex education, access to specialized care, HPV vaccination and smoking prevention would help reduce the appearance of new cases of the disease. Encouraging research of new risk factors would also help in better prevention of the disease.