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Risk Factors for Penile Cancer: What Raises Your Risk and What Lowers It
A risk factor is anything that raises the chance of getting a disease. Some risk factors can be changed and some cannot. Knowing the risk factors for penile cancer is useful for two reasons: a few of them can be acted on, and knowing you have one is a good reason to look at your own skin and speak up early. Penile cancer is rare. The American Cancer Society estimates about 2,260 new cases and about 450 deaths in the United States in 2026, and it is diagnosed in fewer than 1 in 100,000 men each year. Having a risk factor, even several, does not mean you will get it.
What Raises Your Risk for Developing Penile Cancer?
Researchers have identified a clear set of risk factors, and most of them work through the same two pathways: long-lasting infection with certain types of HPV, and long-lasting irritation or inflammation of the skin of the penis. Nearly all penile cancers are squamous cell carcinomas, meaning they start in the flat skin cells that cover the glans and foreskin, and anything that keeps those cells damaged or infected for years raises risk.
HPV infection, especially HPV 16: HPV (human papillomavirus) is a very common virus passed through intimate contact. The CDC estimates that about 60% of penile cancers are linked to HPV. Most infections clear on their own within about two years, but when a high-risk type stays for many years, it can slowly change normal cells into cancer cells. HPV 16 is the type most often found in penile cancer.
Not being circumcised, particularly along with phimosis: Penile cancer is uncommon in men who were circumcised as newborns. Part of the reason appears to be that the closed space under the foreskin makes it easier to get and to keep an HPV infection, and easier for irritation to continue unnoticed. The risk is highest when a foreskin is present together with phimosis.
Phimosis: Phimosis means the foreskin cannot be pulled back over the glans. It makes the penis hard to clean and hard to inspect, and it may raise the chance of HPV infection. Orchid, a United Kingdom male cancer charity, reports that men with phimosis are about 10 times more likely to develop penile cancer.
Smegma buildup and chronic irritation: Smegma is the natural mix of skin cells and oil that collects under the foreskin. Smegma by itself is not considered a cause of cancer. The concern is that when it cannot be washed away, it keeps the skin irritated and inflamed for years, and long-term inflammation is a known risk factor.
Lichen sclerosus: This is a skin condition that causes white, itchy, tight patches on the glans and foreskin. It used to be called balanitis xerotica obliterans. It is the most common precancerous penile skin condition that is not caused by HPV, and roughly 2% to 9% of men who have it may eventually develop penile cancer.
Smoking and chewing tobacco: Tobacco in any form raises risk. Chemicals from tobacco enter the blood, travel through the body, and can damage the genes inside penile skin cells. Men who smoke cigarettes are reported to be about 3 to 4.5 times more likely to develop penile cancer than men who do not.
HIV, AIDS, and other causes of a weakened immune system: Men living with HIV have a higher risk, roughly 8 times higher. A weaker immune system has a harder time clearing HPV. Medicines that suppress the immune system, such as those taken after an organ transplant, also raise risk.
PUVA treatment for psoriasis: PUVA combines a drug called psoralen with ultraviolet A light and is used for stubborn psoriasis. Men treated with PUVA have a higher rate of penile cancer, and the risk goes up with higher total doses.
Age over 50 to 60: Risk climbs steadily with age. The average age at diagnosis in the United States is about 60, and the National Cancer Institute lists being 60 or older as a risk factor. Penile cancer in younger men happens but is unusual.
Geography and access to care: Penile cancer is uncommon in North America and Europe and much more common in parts of Asia, Africa, and South America. Within the United States, rates are higher among Hispanic men and in counties with lower incomes in the South, which points to differences in access to care as well as biology.
Number of sexual partners and a history of genital warts: More partners over a lifetime means more chances of being exposed to HPV. The types of HPV that cause genital warts are not the same types that cause penile cancer, but men who have had genital warts still have a higher risk, probably because exposure to one type often means exposure to others.
None of these risk factors will tell you whether a change on your skin is cancer. There is no standard screening test for penile cancer, which our guide on penile cancer screening explains in more detail. That makes paying attention to penile cancer symptoms more important than sorting out your risk score. If you have any of these risk factors, mention them to your doctor and ask to have your penis examined at your regular visits.
Factors That May Lower Your Risk of Penile Cancer
The large differences in penile cancer rates around the world suggest that many cases could be prevented. Because the disease is rare to begin with, no single step will drop your risk to zero, and some men develop penile cancer with nothing on this list to avoid. Still, most of the steps below are good for your health in other ways too, which makes them easy to justify.
HPV vaccination: The HPV vaccine protects against the types of HPV that cause most HPV-related cancers, including HPV 16. It works best when it is given before any exposure to the virus, which is why the CDC recommends two doses at ages 11 to 12 and allows the series to start at age 9. Vaccination is also recommended through age 26 for people who missed it, and the National Cancer Institute notes the vaccine is estimated to prevent up to 90% of cancers caused by HPV. Direct proof that it lowers penile cancer specifically is still limited, because the disease is so rare, but the biology points the same direction.
Circumcision, with honest nuance: Circumcision in infancy is linked to much lower rates of penile cancer. Circumcision as an adult does not appear to give the same protection. For an adult man who already has a foreskin, there is no need to rush into surgery for cancer prevention alone but to treat phimosis if it is present, wash gently and regularly, and get any lesion looked at quickly. Circumcision remains a personal and cultural decision, and it is worth discussing with your own doctor rather than deciding from a statistic.
Treating phimosis: Phimosis is treatable. Doctors often start with a prescription steroid cream or ointment that makes the foreskin more flexible so it can be pulled back. If that is not enough, a small procedure called a dorsal slit can make the foreskin easier to retract, and circumcision is another option. Treating phimosis makes the skin easier to clean and much easier to inspect.
Daily gentle washing under the foreskin: If you are not circumcised, pull the foreskin back once a day, rinse the glans and the inner foreskin with warm water and a mild soap or with water alone, pat dry, and return the foreskin to its usual position. Gentle is the point. Harsh soaps and vigorous scrubbing cause the same irritation you are trying to avoid. This habit doubles as your monthly look at your own skin.
Not smoking or using tobacco: Quitting tobacco, or never starting, lowers the risk of penile cancer along with many other cancers. If you want help, the National Cancer Institute maintains free quitlines and tools, and your care team can prescribe medicines that make quitting easier.
Using condoms: Condoms used correctly and consistently lower the chance of passing HPV, though they do not prevent it completely, because HPV lives on skin that a condom does not cover. One urology reference reports that not using condoms regularly roughly doubles penile cancer risk. Condoms also reduce other sexually transmitted infections that add to chronic irritation.
Treating lichen sclerosus: Lichen sclerosus is usually managed with strong steroid ointments and regular follow-up with a urologist or dermatologist. Treatment eases symptoms, and ongoing checks mean that if the skin does start to change, it is caught early rather than years later.
Managing HIV with antiretroviral therapy: Antiretroviral therapy is the daily medicine that keeps HIV under control. A well-controlled immune system is better able to clear HPV infections on its own, so staying on treatment and keeping your appointments is part of lowering your overall cancer risk. Ask your HIV provider to include a genital skin exam in your routine care.
Getting any lesion evaluated promptly: This is the step with the clearest payoff. Standard urology guidance is that any lesion on the penis should be evaluated by a clinician as soon as possible, because prompt diagnosis allows treatment at an earlier stage with better survival and better cosmetic results.
Notice how much of the list is really one idea repeated: keep the skin of the penis healthy, uninflamed, and easy to see. Vaccination, condoms, and quitting tobacco reduce the damage arriving from outside. Treating phimosis and lichen sclerosus and washing gently reduce the damage happening on the surface. Getting a lesion checked early keeps a small problem from becoming a large one.
It is also worth separating prevention from early detection. What you can almost always do is shorten the time between noticing a change and being seen. That single habit has more influence on outcomes than any other item here, because penile cancer found early is highly curable.
Quitting tobacco, treating lichen sclerosus on the remaining skin, and keeping every follow-up appointment all matter during and after treatment. Our guides on penile cancer prevention and penile cancer support go further into both.
Whatever your results show, the next step is a conversation with your own care team about what the findings mean for you and what you want to do next.
What’s Next: Click the Penile Cancer Guide page to see all the guides about Penile cancer.