Introduction: The process of centralization of Penile Squamous Cell Carcinoma (PSCC) care in the Netherlands was initiated around 1990 and based on acknowledgement of one national center of expertise. Other regional PSCC centers should have an annual caseload of =10 T1aG1 patients per year and experience in high-level multidisciplinary care. The aim of this study was to evaluate incidence and centralization trends, and the potential benefit on overall survival of centralization of PSCC care in the Netherlands. Methods: All new PSCC diagnoses between 1990-2020 were retrospectively identified from the Netherlands Cancer Registry (NCR), a population-based cancer registry with nationwide coverage. Cancer diagnoses are reported by registry of histology after which the NCR can provide per-patient data on age, clinical and pathological tumor staging, follow-up and vital status. All patients that were treated in the national referral center (NCI, Amsterdam) were known, all other patients were treated at one of the regional centers (anonymity kept by NCR). Overall survival (OS) was calculated with multivariate cox regression analysis, with T- and N-stage, treatment at the NCI (y/n) and age as independent variables. Results: In total, 3276 patients were diagnosed with PSCC in the Netherlands. There was a significant incidence increase, from 0.92 per 100,000 men in 1990 to 1.83 per 100,000 men in 2020. The percentage of NCI-patients increased from 1% to 63% during this period, while in other centers it decreased from 99% to 37%. The median age of NCI-patients was 68 years and 70 years in other centers. At the NCI, 27% of the patients had lymph node metastases (pN+), compared to 10% in other centers (p-value <0.001). Despite of this, and corrected for T-, N-stage and age, the OS of NCI-patients was higher compared to patients in other centers (HR 1.29, 95% CI 1.13–1.47, p-value=0.001). The median OS at the NCI is 10 years (IQR 9–11 years) and in other centers 7 years (IQR 7–8 years). Conclusions: PSCC incidence in the Netherlands is rising and centralization of care has increased. Despite a relatively higher N-stage at presentation, patients treated at the national referral center of expertise seem to have higher OS, suggesting a beneficial effect of centralized care. SOURCE OF Funding: No conflict of interest to declare
