Penile cancer is a rare malignancy with an incidence rate of less than 1:100,000 in the US, but in some developing countries like Brazil, incidence rates are as high as 6.8:100,000. The significant geographic variation in incidence is likely attributed to differences in the prevalence of the human papilloma virus (HPV) infection, smoking, rates of neonatal circumcision, and sociodemographic risk factors.