SURVEILLANCE OF PENILE CANCER IN RWANDA: A FOUR YEAR MULTICENTER PROSPECTIVE RESEARCH PROJECT

Background: Cancer of the penis is rare in developed countries, but it may represent 20-30% of all cancers diagnosed in men in the developing world. In Rwanda, a recent four year retrospective patients’ charts review at University Teaching Hospital of Kigali revealed that 31 patients presented with invasive squamous cell carcinoma of the penis. About ninety per cent of them underwent penile amputation. An overall substandard data record and management was observed. The aim of this research project is to determine the clinical presentation and staging, the risk factors, the histology types, the quality of life and the postoperative 2-year outcome of penile cancer among Rwandans.
Methodology: This is a multicenter prospective analytical case series study involving all male patients presenting at three University Teaching Hospitals in Kigali (CHUK, RMH, and KFH) and the University Teaching Hospital of Butare (CHUB) with penile cancer. It is a 4-year period study, including a 2-year post-treatment follow up. Patient’s characteristics, clinical presentation and presumed risk factors of the disease will be recorded. The management using standardized guidelines, the quality of life and the outcome variables will be recorded on a standardized questionnaire. A multivariate analysis will be used to determine whether phimosis, HPV infection, smoking, chronic inflammatory conditions, lack of childhood circumcision and lack of regular subpreputial hygiene are predictors of penile cancer.
Results: Knowledge of the disease’s burden and risk factors will surely influence education programs about penile hygiene, will reinforce the benefit of childhood circumcision and may influence decision makers to consider also male vaccination against HPV.