PENİS KANSERİ İÇİN RİSK FAKTÖRLERİ VE SÜNNET

Öz

Penis kanseri batı ülkelerinin çoğunda diğer ülkelere göre daha nadir görülür. Penis kanseri tanısı erken dönemde gözlenen ve semptoma yol açmayan lezyonların hastalar tarafından fazla önemsenmemesi ve dikakate alınmaması nedeniyle gecikebilir. Penis kanseri olgularının büyük çoğunluğu skuamöz hücreli kanserdir. Bazı risk faktörleri tanımlanmış olsa da penis kanserinin kesin sebebi tam olarak anlaşılabilmiş değildir. Fimozis penis kanserinin gelişiminde rol aldığı düşünülen konular içinde en fazla bahsi geçen durumlardan biridir. Yapılan bilimsel çalışmaların çoğundan elde edilen sonuçlar yenidoğan veya çocukluk çağında sünnet yapılması ile riskin azalması arasında anlamlı bir ilişki olduğunu göstermektedir. Yine yapılan çalışmaların çoğundaki sonuçlar, çocukluk çağında yapılan sünnetin koruyucu etkisinin fimozis ve balanitis gibi kötü genital hijyen ile ilgili inflamatuvar durumların ortadan kaldırılmasına bağlı olduğunu vurgulamaktadır. Sünnet olmamış kişilerde eğer genital bölge hijyeni kötü ise fimozis olmasa da bu bölgede mikroorganizmalar ve smegma birikimi meydana gelebilir. Birçok çalışmada sigara içiciliğinin de penil skuamöz hücreli kanser riskinde artış ile ilşkili olduğu sonucu elde edilmiştir. İster tedavi amaçlı olsun ister estetik amaçlı olsun ultraviyole radyasyona maruz kalmak da farklı derecelerde penil skuamöz hücreli kanser riskini artırabilir. Kronik irritasyon ve penil travma, kötü genital hijyenle eş zamanlı olarak uzun süreli olarak kimyasal bileşenlere maruz kalmak da penis kanserleri ile ilişkili durumlar olarak yapılan çalışmalarda bildirilmiştir. Dr. Ahmet GÖKÇE, Dr. Mevlana Derya BALBAY

Anahtar Kelimeler

• Penil tümörler; Sünnet; Fimozis
• Penil tümörler
• Sünnet
• Fimozis

CIRCUMCISION AND RISK FACTORS FOR PENILE CANCER

Öz

Penile carcinoma is relatively uncommon in most Western countries. The diagnosis of penil cancer may be delayed because many patients disregard early asymptomatic lesions. Majority of the cases are squamous cell carcinoma (SCO). Although several risk factors commonly are recognized, the exact cause of penis cancer is not definitely known. Phimosis is one of the most mentioned cause in the pathogenesis of penile SCC. Studies have consistently reported neonatal or childhood circumcision to be associated with reduced risk, which corresponds geographically with reduced rates of penile SCC in populations practicing neonatal circumcision. The protective effect of childhood circumcision seems to be attributable to the elimination of inflammatory conditions related to poor genital hygiene, such as phimosis and balanitis. Accordingly, an intact foreskin has been shown not to be associated with increased penile SCC risk in the absence of phimosis. Poor genital hygiene in uncircumcised men, even in the absence of phimosis, may also lead to the retention of microorganisms and secretions, including smegma. Tobacco smoking, particularly current smoking, has been reported in a number of studies to be linked to increased risk of penile SCC. Ultraviolet radiation exposure, either therapeutic or recreational, may increase the risk of penile SCC. Human papillomavirus has been implicated as a causal agent in penile cancer, suggesting that this cancer may be a sexually transmitted disease. Chronic irritation or trauma and prolonged exposure to chemical compounds together with poor hygiene have been reported in association with penile SCC.

Anahtar Kelimeler

• Penile Neoplasms
• Circumcision
• Phimosis

Kaynakça

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