Causes and risk factors of penile cancer

Certain factors may increase the risk of penile cancer. These can include having human papilloma virus (HPV), having a tight foreskin, smoking, certain skin conditions, and being over the age of 50.

What are risk factors?

The exact cause of penile cancer is not known. There are certain things that can increase the risk of developing penile cancer. These are called risk factors. Having a risk factor does not mean you will get cancer. And not having any risk factors does not mean that you will not get cancer.

If you are worried about penile cancer and would like to talk to someone, we're here. You can:

Call the Macmillan Support Line on 0808 808 00 00.
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The human papilloma virus (HPV)

The human papillomaviruses (HPVs) are a group of common infections that affect the skin and the moist lining inside parts of the body. This is called the mucous membrane. HPV is most common inside the mouth, throat, genital area and anus.

HPV passes easily from person to person during any type of sexual contact, including skin-to-skin genital contact, oral sex or sharing sex toys.

Most people will have it at some point in their life. Usually, the virus does not cause any damage and there are no symptoms. Most people do not know they have it.

There are more than 100 types of this virus. Most types are not linked to cancer. Some types of high-risk HPV can increase the risk of developing certain cancers. But most people infected by high-risk HPV do not develop cancer.

Usually, the body’s immune system gets rid of the virus.

For some people, the immune system does not get rid of the infection. We do not know exactly why that is. If the virus stays in the body for longer, it may cause damage to cells. These can then develop into cancer.

HPV infection is often found in penile cancer. Some types of HPV cause genital warts, which can increase the risk of penile cancer.

Penile cancer itself is not infectious. You cannot catch cancer or pass it on to other people.

We have more information about HPV.

Having a tight foreskin

Penile cancer is more common if you have a tight foreskin that does not pull back easily. This is called phimosis. The reason for this is not known. It may be because having a tight foreskin can make it difficult to pull back the skin to clean the penis. This can lead to a build-up of dead cells called smegma under the foreskin. The build-up can cause irritation and inflammation of the penis.

Penile cancer is extremely rare if you are circumcised. Circumcision means having all or part of your foreskin removed.

Certain skin conditions

Some skin conditions that affect the penis may develop into cancer if they are not treated. These include lichen sclerosus.

Always see your GP if you have:

white or red scaly patches on the head of the penis
moist red patches of skin on the penis.

Having PUVA treatment for psoriasis

Psoriasis is a chronic skin condition. Sometimes it is treated by combining medicines called psoralens with light therapy. This is known as phototherapy. This treatment is called Psoralen-UV-A Photochemotherapy (PUVA).

PUVA treatment given over a long time can cause premature ageing changes to skin cells. This increases the risk of some types of skin cancer, including those that can affect the penis.

Having a weakened immune system

If you have a weakened immune system, you may be at higher risk of penile cancer.

Conditions like HIV or AIDS lower the immune system. This makes it harder for your body to fight infection.

If you have had an organ transplant, the drugs you take to stop your body rejecting the transplant supress (lower) your immune system. This means you are more likely to get infections.

Smoking

Smoking can increase the risk of penile cancer.

Age

Most penile cancer is diagnosed in people over the age of 50.

About our information

References

Below is a sample of the sources used in our penile cancer information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk

EAU Guidelines: Penile Cancer. Available from: uroweb.org/guideline/penile-cancer (accessed May 2022).

Penile cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up. Available from: www.annalsofoncology.org/article/S0923-7534(19)31556-X/pdf (accessed May 2022).

Reviewers

This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Dr Ursula McGovern, Consultant Medical Oncologist.

Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.

The language we use

We want everyone affected by cancer to feel our information is written for them.

We want our information to be as clear as possible. To do this, we try to:

use plain English
explain medical words
use short sentences
use illustrations to explain text
structure the information clearly
make sure important points are clear.

We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.

You can read more about how we produce our information here.