Social deprivation trends in operative penile cancer
Rewhorn, MJ1; Wu, D1; Hendry, DS1; Fraser, M1
1: NHS Greater Glasgow & Clyde, United Kingdom
Objectives: Penile cancer is a rare disease and accounts for less than 1% of total cancers diagnosed. Scotland has a higher incidence of penile cancer compared to many parts of the world and can have serious functional and sexual consequences for patients. Does social deprivation play a role in presentation, grade, stage and ultimate treatment of penile cancer?
Materials & Methods: All cases of penile cancer in Glasgow, Scotland, an area of centralized NHS service, were identified over a 10-year period. Patients identified from operative notes performed by two consultant urologists from 2007 – 2017 were included. Social deprivation was determined using the Scottish Index of Multiple Deprivation (SIMD), the Scottish Government’s official tool to identify areas of multiple deprivation in Scotland.
Results: 200 patients were identified with an age range of 27 – 91 (mean = 63). The most deprived areas have a significantly higher number of cases of penile cancer [Table 1]. Moreover, histologically, a higher proportion of aggressive grade 3 cancers were diagnosed in the most deprived population and also more advanced staging [Table 2]. There is a significantly higher rate of penile amputation in the more socially deprived population [Table 3]. Patients took an average of 6 months to present to primary care and although there was no correlation in the number of missed appointments and social deprivation, a total of 200 appointments were missed.
Conclusion: In conclusion, from a health promotion viewpoint, the most deprived are at higher risk of developing penile cancer and therefore efforts should be made to raise awareness for earlier diagnosis, which would lead to better functional and sexual outcomes. The stigma of penile cancer and sexual health needs to be addressed to allow earlier diagnosis and thus prevent potentially more disfiguring surgery.
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