Precancerous conditions of the penis
Precancerous conditions of the penis are changes to penile cells that make them more likely to develop into cancer. These conditions are not yet cancer. But if they aren’t treated, there is a chance that these changes will become penile cancer.
The most common precancerous condition of the penis is penile intraepithelial neoplasia (PeIN). PeIN refers to abnormal cell changes that are only in the top layers of the skin of the penis.
PeIN is now used as a general term to describe all precancerous conditions of the penis that may develop into invasive squamous cell carcinoma (SCC) if they aren’t treated. PeIN includes conditions that were previously known as erythroplasia of Queyrat, Bowen’s disease and Bowenoid papulosis.
PeIN, also called
Types of PeIN
There are 2 types of PeIN, based on whether or not they’re linked to an infection with the human papillomavirus (HPV).
HPV-associated PeIN is linked to an HPV infection. It’s the most common type of PeIN.
HPV-independent PeIN, also known as differentiated-type PeIN, is less common. It’s not linked to an HPV infection but often occurs when there is a skin condition called balanitis xerotica obliterans (BXO, also called penile lichen sclerosus). BXO can make skin itchy and cause white patches due to inflammation of the skin.
Both types of PeIN are considered
Risks
The following risks increase your chance of developing PeIN:
- HPV infection
- balanitis xerotica obliterans (BXO)
- poor genital hygiene
-
immunosuppression - smoking tobacco
-
exposure to ultraviolet (UV) light, including
PUVA therapy - foreskin not being removed (being uncircumcised)
Circumcision may help reduce the risk of an HPV infection. It may lower the risk of penile cancer when done at a very young age, but it has not been shown to prevent penile cancer when done in adulthood. The decision to undergo circumcision is often personal and not always based on medical reasons. Talk to your doctor if you’re considering circumcision for yourself or your child.
Find out more about HPV.
Symptoms
The signs and symptoms of PeIN include:
- abnormal growths or open sores (ulcers) on the penis that may be raised or flat, with irregular borders, discolouration, scaling, bleeding or itching
- painful urination
- discharge from the penis
- a thickened and tightened foreskin that is more difficult to pull back (retract) than usual (phimosis)
Diagnosis
If you have symptoms or your doctor thinks you might have PeIN, you will be sent for tests. Tests used to diagnose PeIN may include:
- an examination of the penis
- a biopsy of the abnormal area
Treatments
Treatment options for PeIN include:
-
topical therapy (an ointment or cream) such as imiquimod (Aldara) or fluorouracil (also called 5-fluorouracil or 5-FU) - cryosurgery
- glans resurfacing surgery to remove the top layers of the abnormal tissue on the head of the penis (glans)
- Mohs surgery
Find out more about surgery for penile cancer.
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