LAUSR

BACKGROUND Penile squamous cell carcinoma (PSCC) survival had no significant improvement since 1990 in the United States. This study aims to get insight into the changing trend and distribution of death causes of PSCC. The epidemiology of PSCC is also investigated. METHODS The Surveillance, Epidemiology, and End Results (SEER) (1992-2018) database is utilized to get patients diagnosed with penile squamous cell carcinoma. The trend of incidence, distribution of age, changing trend and distribution of death cause, and survival outcome are analyzed for all PSCC patients and each race. RESULTS Three thousand four hundred and twenty-three male patients with PSCC are enrolled in our study. The age-adjusted incidence rate of the white has a slight increase (Annual percent change [APC] = 0.647%). American Indian/Alaska Native men have the highest average annual incidence, while Asian /Pacific Islander men have the lowest. PSCC patients aged 70-80 are the most common, and patients over 80 years have the highest 3-year (50%) and 5-year (63.93%) mortality rate. Non-cancer disease, especially circulatory system disease, is the most common cause of death, whereas the proportion of patients who died of PSCC significantly increased from 21.17% (1992-2001) to 41.3% (2012-2017) in PSCC patients (p < 0.001). These results have not changed significantly when we only focus on primary PSCC without previous malignant tumors. Hispanics are shown better overall survival than non-Hispanic White and non- Hispanic Black men. (p < 0.001) No statistical differences in cancer-specific survival are observed (p = 0.15). CONCLUSION The current study provides essential initial data regarding the presentation and clinical outcomes of PSCC patients. Notably, non-cancer disease, especially circulatory system disease, is the more common cause of death than PSCC. However, the proportion of patients who died of penile squamous cell carcinoma has a relatively significant increase in recent years. The increasing trends in the advanced stage of PSCC patients might account for this change.