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We examined levels of interobserver and intraobserver agreement in assessment of histological subtype and grade in 207 patients with penile squamous cell carcinoma. The cases were assessed by seven pathologists from three hospitals located in Sweden and Italy. There was poor to moderate concordance in assessing both histological subtype and grade, with Fleiss kappas of 0.25 (range: 0.02\u20130.48) and 0.23 (range: 0.07\u20130.55), respectively. When choosing HPV-associated and non-HPV-associated subtypes, interobserver concordance ranged from poor to good, with a Fleiss kappa value of 0.36 (range: 0.02\u20130.79). A re-review of the slides by two of the pathologists showed very good intraobserver concordance in assessing histological grade and subtype, with Cohen\u2019s kappa values of 0.94 and 0.91 for grade and 0.95 and 0.84 for subtype. Low interobserver concordance could lead to undertreatment and overtreatment of many patients with penile cancer, and brings into question the utility of tumor histological subtype and tumor grade in determining patient treatment in pT1 tumors.<\/jats:p>","DOI":"10.1007\/s00428-021-03249-5","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T08:05:45Z","timestamp":1639123545000},"page":"879-886","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Low level of interobserver concordance in assessing histological subtype and tumor grade in patients with penile cancer may impair patient care"],"prefix":"10.1007","volume":"480","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1530-5045","authenticated-orcid":false,"given":"Luiza","family":"Dorofte","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8425-5833","authenticated-orcid":false,"given":"Diane","family":"Gr\u00e9laud","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1749-150X","authenticated-orcid":false,"given":"Michelangelo","family":"Fiorentino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Giunchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7254-4195","authenticated-orcid":false,"given":"Costantino","family":"Ricci","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tania","family":"Franceschini","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3673-532X","authenticated-orcid":false,"given":"Mattia","family":"Riefolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2850-6009","authenticated-orcid":false,"given":"Sabina","family":"Davidsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-7592","authenticated-orcid":false,"given":"Jessica","family":"Carlsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9992-266X","authenticated-orcid":false,"given":"Gabriella","family":"Lillsunde Larsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-237X","authenticated-orcid":false,"given":"Mats G.","family":"Karlsson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"3249_CR1","first-page":"e117","volume":"41","author":"CE Montes Cardona","year":"2017","unstructured":"Montes Cardona CE, Garc\u00eda-Perdomo HA (2017) Incidence of penile cancer worldwide: systematic review and meta-analysis. 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