Association between neighborhood deprivation and stage at diagnosis in penile squamous cell carcinoma
Recommended Citation
Silvani C, Tylecki A, Santangelo A, Considine J, Mssika A, Robinson B, Salka B, Nazzani S, Salonia A, Briganti A, Montorsi F, Nicolai N, Montanari E, Rogers C, Abdollah F. Association between neighborhood deprivation and stage at diagnosis in penile squamous cell carcinoma. Eur Urol 2026; 89:1.
Document Type
Conference Proceeding
Publication Date
3-1-2026
Publication Title
Eur Urol
Keywords
Urology & Nephrology
Abstract
Introduction & Objectives: Penile squamous cell carcinoma (SCC) is a rare malignancy influenced by socioeconomic and access-to-care factors. The Area Deprivation Index (ADI) is a validated measure of neighborhood-level socioeconomic disadvantage, yet its relationship with penile cancer stage at diagnosis remains unexplored. We aimed to assess the association between ADI and advanced-stage disease at presentation in a statewide cohort. Materials & Methods: We retrospectively analyzed patients diagnosed with penile SCC in Michigan (2004–2019) using the state cancer registry. ADI scores were assigned based on patients' residential census block and expressed as national percentiles (1–100; higher = greater deprivation). Advanced disease was defined as pathological T stage ≥2 or nodal involvement (N+) or distant metastasis (M+). Univariable and multivariable logistic regression models evaluated the association between ADI (per 10-point increase) and advanced stage, adjusting for age, race, insurance type, grade, and year of diagnosis. Results: Among 353 patients (median age 72; 84.4% White), the median ADI was 69 (IQR 50–85); 76% resided in high-ADI areas. Black patients were more represented in the high-ADI group (15.3% vs. 2.4%, p=0.003). Advanced-stage disease occurred more frequently among high-ADI patients (49.3% vs. 36.5%, p=0.04). In multivariable analysis, each 10-point increase in ADI was associated with 16% higher odds of presenting with advanced disease (OR 1.16, 95% CI 1.04–1.29, p=0.02). This association remained significant after adjusting for age, race, insurance status, pathological grade, and year of diagnosis. Conclusions: Greater neighborhood-level socioeconomic deprivation is independently associated with advanced-stage presentation of penile SCC, even after accounting for other relevant factors. These findings suggest that neighborhood disadvantage may delay diagnosis and influence disease severity at presentation, underscoring the importance of community-based awareness and early referral strategies in high deprivation areas.
Volume
89
First Page
1
