# Epidemiology of Primary Urethral Cancer: Insights from Four European Countries with a Focus on Poland

## TL;DR

This study examines how often urethral cancer occurs and causes death in four European countries, emphasizing the rarity of the disease and the need for better data and specialized care.

## Contribution

The study provides the first contemporary comparative analysis of primary urethral cancer epidemiology in Europe, highlighting data gaps and suggesting centralization of care to improve outcomes.

## Key findings

- Primary urethral cancer is rare and shows significant variation in incidence and mortality across Europe.
- Poland has the lowest incidence but stable mortality rates for primary urethral cancer.
- Centralization of care is suggested as a potential strategy to improve patient outcomes for rare cancers like urethral cancer.

## Abstract

Primary urethral cancer is a very rare cancer of the urinary tract, and current information on how often it occurs and causes death in Europe is limited and often outdated. This makes it difficult to understand the scale of the problem and to improve patient care. In this study, the authors analyzed the most recent population-based cancer registry and mortality data from selected European countries, with a particular focus on Poland. The aim was to compare differences in disease occurrence and death rates between countries and over time. The results confirm that primary urethral cancer is uncommon, affects men more often than women, and shows clear variation across Europe. By identifying gaps in data availability and highlighting the potential role of specialized treatment centers, this study provides valuable insights for researchers and clinicians working to improve outcomes in rare cancers.

Background/Purpose: Primary urethral cancer is a rare malignancy, accounting for less than 1% of all urogenital cancers. Current epidemiological data from Europe are scarce and outdated. Therefore, the analyzes and comparison of the incidence and mortality of PUC in selected European countries, with particular focus on Poland, based on the most recent available registry data, were performed. Methods: Our study is based on country-level data and is descriptive in nature. Incidence data for PUC were obtained from the national cancer registries of Poland, Latvia, Slovenia, and Hungary. Mortality data were sourced from the WHO Mortality Database. Age-standardized incidence rates were calculated for two time intervals (2000–2009 and 2010–2019). Age-standardized mortality rates for individuals aged ≥45 years were calculated using the European Standard Population (ESP2013). Trends in incidence and mortality in Poland were analyzed using a five-year moving average. Results: The highest incidence of PUC was observed in Hungary, while Poland showed the lowest incidence. Latvia had the highest ASMRs for both sexes, whereas Poland and Greece reported the lowest mortality rates. Despite slight annual fluctuations, the overall PUC mortality rate in Poland has remained stable. Our study is limited by the relatively short analyzed period (2000–2021), restricted availability of C68.0 incidence data from national cancer registries, and incomplete mortality data in the WHO mortality database. Conclusions: This first contemporary comparative analysis of PUC epidemiology in Europe highlights the rarity of this malignancy and the limited data availability. Based on the knowledge drawn from the literature presented in the article on the impact of centralization on the increase in overall survival and the decrease in mortality in rare cancers, the authors believe that centralization of care can improve PUC patient outcomes.