Rare tumours such as penile carcinoma have been largely neglected by the urology scientific community in favour of more common - and, therefore, more easily fundable - diseases. Nevertheless, penile cancer represents a rising burden for health-care systems around the world, because a lack of widespread expertise, ineffective centralization of care and absence of research funds have hampered our ability to improve the global care of these patients. Moreover, a dichotomy has arisen in the field of penile cancer, further impeding care: the countries that are mainly supporting research on this topic through the development of epidemiological studies and design of clinical trials are not the countries that have the highest prevalence of the disease. This situation means that randomized controlled trials in developed countries often do not meet the minimum accrual and are intended to close before reaching their end points, whereas trials are almost completely absent in those areas with the highest disease prevalence and probability of successful recruitment, such as Africa, South America and South Asia. The scientific and organizational inaction that arises owing to this mismatch translates into a burdensome cost for our patients. A global effort to gather experts and pull together scientific data from around the world may be the best way to boost clinical research, to change clinical practice and, ultimately, to improve care for patients and their families.
Nature reviews. Urology. 2021 Dec 22 [Epub ahead of print]
Marco Bandini, Mohamed Ahmed, Giuseppe Basile, Nicholas Watkin, Viraj Master, Yao Zhu, Gagan Prakash, Alejandro Rodriguez, Mbaaga K Ssebakumba, Riccardo Leni, Giuseppe Ottone Cirulli, Ben Ayres, Rachel Compitello, Filippo Pederzoli, Pankaj M Joshi, Sanjay B Kulkarni, Francesco Montorsi, Guru Sonpavde, Andrea Necchi, Philippe E Spiess
Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy. ., Moffitt Cancer Center and Research Institute, Tampa, FL, USA., Urological Research Institute (URI), IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy., St George's University Hospitals, NHS Foundation Trust, London, UK., Emory University School of Medicine, Department of Urology, Atlanta, GA, USA., Fudan University Shanghai Cancer Center, Shanghai, China., Department of Urosurgery, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India., Urology Associates of Rochester, Rochester General Hospital, Rochester, NY, USA., Uro Care Hospital, Kampala, Uganda., Kulkarni Reconstructive Urology Center, Pune, India., Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.