Penile cancer in French Guiana: Epidemiology, histopathology and clinical aspects.

Objectives: To study the characteristics of penile cancer in French Guiana (FG)- a French overseas department in South America. Indeed, penile cancer is a rare malignancy with significant geographic and socioeconomic disparities. While its epidemiology is well-documented in mainland France, data from FG remain limited. Patients and Methods: We conducted a retrospective analysis of 22 cases of primary penile cancer diagnosed between 2004 and 2024 at the Centre Hospitalier de Kourou. Demographic, clinical, histopathological, and risk factor data were collected and reviewed. Results: The average incidence was 1.07 cases per year, with a mean age at diagnosis of 54.9 years. Notably, 19% of patients were under 40 years. The Bushinengue population (descendants of escaped African slaves) accounted for 54.5% of cases. The most common risk factor was lack of circumcision (100%), followed by HPV-16 infection (40.9%). Most tumours were exophytic (68.2%), distal (72.7%), with a median size of 3.5 cm. Squamous cell carcinoma was the predominant histological type (90.9%), with 56.3% being well differentiated. Lymph node involvement was present in 68.2% of patients. Conclusion: The incidence of penile cancer in FG appears higher than in neighbouring regions, potentially due to regional underreporting and cross-border healthcare access. The disproportionate impact on the Bushinengue population, younger age at diagnosis and advanced disease at presentation likely reflect cultural practices, low circumcision rates and barriers to early care. This first study on penile cancer in FG highlights the role of non-circumcision and HPV-16 infection as major risk factors. Public health efforts should prioritize HPV vaccination and early diagnostic access in vulnerable populations.