DEMOGRAPHIC DISPARITIES IN PENILE CANCER IN APPALACHIA: A MULTI-INSTITUTIONAL, STATEWIDE REVIEW

• Published in: Urologic oncology 2024-03, Vol.42, p.S66-S66
• Main Authors: Zekan, David, Pettit, Andrea, Gish, Charles, Salisbury, Frances, Luchey, Adam, Hajiran, Ali, Novak, Mary, Deem, Samuel, Hale, Nathan, Haffar, Ahmad, Williams, Andrew
• Format: Article
• Language: English
• ISSN: 1078-1439; 1873-2496
• DOI: 10.1016/j.urolonc.2024.01.190

Known disparities exist amongst HPV-related cancer outcomes in urban versus;rural populations, including squamous cell carcinoma (SCC) of the penis.; Appalachia as a whole, and West Virginia specifically, present a unique opportunity for analysis of penile cancer in underserved areas with few tertiary care centers and large distances and travel time;between centers.; The majority of patients in the state seek urologic oncology care at two tertiary centers.; This study seeks;to examine;differences in penile cancer presentation (including TNM stage,;grade, pertinent risk factors,;presenting symptoms and duration), treatment, and outcomes;between rural and urban populations in West Virginia.; Identification of disparities is crucial in detecting disease;to provide earlier intervention and improve outcomes in a traditionally underserved population. Following approval from institutional review boards, 89;patients with biopsy-proven SCC of the penis treated at Charleston Area Medical Center (CAMC) and West Virginia University over a fourteen-year period (2007-2022) were studied via retrospective chart review.; Distance and travel time from the respective tertiary care centers were collected based on zip code, and patients were stratified into urban and rural groups according to county based on the US Census Burea defition of Census Places >10,000.; T-stage, clinical node positivity, grade, risk factors (circumcision, smoking), primary tumor size and location, and treatment modality (chemotherapy, radiation, local therapy vs. partial penectomy vs. radical penectomy) and timing (symptom duration and time from presentation to surgery);were analyzed.; Patients were also followed post-operatively to assess the endpoints of death from penile cancer and local/nodal/distant recurrence.; Appropriate statistical tests were performed using SPSS. Patients;further from;tertiary care centers;(travel time) were more likely to undergo radical penectomy as primary therapy;(p=0.03), although advanced stage;(pT2 or greater) and clinical nodal status at diagnosis;did not increase;with travel time.; Those living;in counties classified as “urban”;had higher BMI on average (p=0.004) and were more likely to present with a lesion on the penile shaft (p=0.06).; No significant;difference exists in stage or grade at diagnosis, other risk factors;(smoking status, circumcision), primary tumor size,;clinically palpable lymph nodes, radiation and chemotherapy use, symptom duration, or timing o