The Evolving Landscape of Viral, Immune, and Molecular Biomarkers in Penile Cancer.

Penile cancer is relatively rare in North America and Europe (<1% of all malignant neoplasms); however, it remains a significant health concern with a higher propensity of cases in many African, South American, and Asian countries. It occurs primarily in older men with a peak incidence in the 6th decade of life. The etiology of penile cancer is multifactorial and there are many risk factors including lack of neonatal circumcision, chronic inflammation, lichen sclerosis, tobacco use, obesity, poor hygiene, exposure to ultraviolet radiation, history of sexually transmitted diseases, and human papillomavirus (HPV) infection. Pathogenesis of penile squamous cell carcinoma (PSCC) can be broadly dichotomized into HPV related and non-HPV-related pathways which will be discussed in detail in this review.