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Abstract
A 40-Year Comparative Study: Temporal trends of Male Primary Urethral Carcinoma: Potential Impact of Reduced Arsenic Exposure in Taiwan versus the USA
Podium Abstract
Clinical Research
Oncology: Urethra/ Penis/ Testes/ Sarcoma/ Miscellaneous
Author's Information
2
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Taiwan
Chen Wei-An wayne971102@gmail.com National Cheng Kung University Hospital Department of Urology Tainan Taiwan *
Tsai Yuh-Shyan youh@mail.nclu.edu.tw National Cheng Kung University Hospital Department of Urology Tainan Taiwan -
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Abstract Content
Primary urethral cancer (PUC) is linked to chronic arsenic exposure in drinking water in Taiwan in prior resarch. Public health measures was done to reduce this exposure. Therefore, we aimed to investigate temporal trends of male PUC in Taiwan compared to the USA.
We conduted retrospective analysis of male PUC patients at National Cheng Kung University Hospital (NCKUH) from 1975-2020, compared with Surveillance, Epidemiology, and End Results (SEER) database trends in the USA. Patients were divided into diagnostic years of 1975-2001 or 2002-2020.
From 1975-2020, 24 and 641male PUC patients from NCKUH and SEER were analyzed respectively. In NCKUH, a marked decrease in adenocarcinoma (43% to 0%) with a corresponding increase in transitional cell carcinoma (TCC, 21% to 90%). Predominant site of PUC shifted from bulbomembranous to penile urethra. SEER data indicated a trend towards advanced stages (31% to 38%, p =0.005). A significant decrease in PUC incidence (3 to 1.4 per million, p <0.001), particularly for TCC (2 to 0.8 per million, p <0.001), with annual percentage change of -3.7 per million.
Our analysis revealed three key trends. 1. Histologic patterns at NCKUH shifted to resemble those in the USA, reflecting reduced arsenic exposure in Taiwan. 2. PUC incidence in the USA significantly decreased, possibly related to declining HPV prevalence. 3. Increased proportion of advanced-stage diagnoses may be attributed to stage migration due to enhanced diagnostic tools like CT scan.
Primary urethral cancer, Chronic arsenic exposure, Incidence rate, Time trend, Histology, Stage migration
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Table 1. Change in incidence of male primary urethral cancer in NCKUH
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Table 2. Change in incidence of male primary urethral cancer in SEER database
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Table 3.Trends in incidence of male primary urethral cancer per 100,000 persons during 1975 to 2015 in SEER database
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Fig 1. Age-standardized incidence rates of male primary urethral cancer per 100,000 persons in the United States from 1975 to 2020 according to histological subtypes and pathological stages at diagnosis.
 
 
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