{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T05:27:47Z","timestamp":1786512467406,"version":"build-2736575974"},"reference-count":11,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>\n                    Basal cell carcinoma (BCC) arising in sun-protected genital sites is uncommon and lies outside the typical ultraviolet-driven model of disease. We retrospectively reviewed 41 patients with primary genital BCC treated at a tertiary referral center in China between January 2010 and December 2025, assessing clinicopathologic features, sex-stratified outcomes, p16 expression, and high-risk human papillomavirus (HPV) DNA status. The cohort included 29 males and 12 females. Female patients were older at diagnosis than male patients (74.8\u202f\u00b1\u202f10.8 vs. 65.4\u202f\u00b1\u202f12.0\u202fyears;\n                    <jats:italic>p<\/jats:italic>\n                    \u202f=\u202f0.019). Nodular BCC was the predominant histologic subtype (29\/41, 70.7%), and aggressive histologic components were present in 7 cases (17.1%). p16 immunoreactivity was detected in 4 of 37 successfully tested cases (10.8%), and high-risk HPV DNA was detected in 2 of 27 successfully tested cases (7.4%). Clinical presentation descriptors were retrospectively extracted from routine medical records and were incompletely documented. During a median follow-up of 51\u202fmonths, five patients developed local recurrence and one male patient developed inguinal lymph node metastasis. In this exploratory cohort, no statistically significant sex-associated difference in recurrence-free survival was detected (log-rank\n                    <jats:italic>p<\/jats:italic>\n                    \u202f=\u202f0.65), but the small number of events precluded inference of equivalent outcomes or exclusion of clinically meaningful sex-related differences. In this Asian cohort, genital BCC was usually nodular, only infrequently associated with detectable high-risk HPV in available tested specimens, and generally favorable after surgery. Because genital lesions may be concealed and clinically non-specific, biopsy should be considered for persistent or suspicious genital lesions, with ongoing postoperative surveillance.\n                  <\/jats:p>","DOI":"10.3389\/fmed.2026.1891922","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:38:23Z","timestamp":1786509503000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Genital basal cell carcinoma in sun-protected sites: sex-stratified clinicopathologic features, p16\/HPV status, and long-term outcomes in an Asian cohort"],"prefix":"10.3389","volume":"13","author":[{"given":"Qiuyan","family":"Duan","sequence":"first","affiliation":[{"name":"Department of Dermatology, The Third Hospital of Hangzhou","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangfeng","family":"Lou","sequence":"additional","affiliation":[{"name":"Department of Urology, The Third Hospital of Hangzhou","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfei","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Urology, The Third Hospital of Hangzhou","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Urology, The Third Hospital of Hangzhou","place":["Hangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1111\/ddg.15566","article-title":"S2k guideline basal cell carcinoma of the skin (update 2023)","volume":"22","author":"Lang","year":"2024","journal-title":"J Dtsch Dermatol Ges"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"666528","DOI":"10.3389\/fpubh.2021.666528","article-title":"Ultraviolet radiation and basal cell carcinoma: an environmental perspective","volume":"9","author":"Teng","year":"2021","journal-title":"Front Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"613533","DOI":"10.3389\/fonc.2020.613533","article-title":"Basal cell carcinoma of the external genitalia: a population-based analysis","volume":"10","author":"Chen","year":"2020","journal-title":"Front Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"255","DOI":"10.1007\/s00403-024-03058-1","article-title":"A systematic review of basal cell carcinoma on the scrotum: reviewing presentation and identifying challenges in management","volume":"316","author":"Demirci","year":"2024","journal-title":"Arch Dermatol Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"8871278","DOI":"10.1155\/2024\/8871278","article-title":"Clinical characteristics of basal cell carcinomas of the scrotum: an institutional retrospective review","volume":"2024","author":"Duan","year":"2024","journal-title":"Dermatol Ther"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1097\/PAS.0000000000002366","article-title":"Clinicopathologic and molecular characterization of basal cell carcinoma arising at sun-protected sites","volume":"49","author":"Draper","year":"2025","journal-title":"Am J Surg Pathol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e27","DOI":"10.1002\/ski2.27","article-title":"Sex disparity in skin carcinogenesis and potential influence of sex hormones","volume":"1","author":"Collier","year":"2021","journal-title":"Skin Health Dis"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"389","DOI":"10.3390\/cancers14020389","article-title":"New insights into the epidemiology of vulvar cancer: systematic literature review for an update of incidence and risk factors","volume":"14","author":"Bucchi","year":"2022","journal-title":"Cancers (Basel)"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1375882","DOI":"10.3389\/fonc.2024.1375882","article-title":"A comprehensive review of current knowledge on penile squamous cell carcinoma","volume":"14","author":"Thumma","year":"2024","journal-title":"Front Oncol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1790","DOI":"10.3390\/diagnostics14161790","article-title":"Exploring the multifactorial landscape of penile cancer: a comprehensive analysis of risk factors","volume":"14","author":"Amicuzi","year":"2024","journal-title":"Diagnostics (Basel)"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.6004\/jnccn.2023.0056","article-title":"Basal cell skin cancer, version 2.2024, NCCN clinical practice guidelines in oncology","volume":"21","author":"Schmults","year":"2023","journal-title":"J Natl Compr Cancer Netw"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1891922\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T04:38:39Z","timestamp":1786509519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1891922\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,12]]},"references-count":11,"alternative-id":["10.3389\/fmed.2026.1891922"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1891922","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,12]]},"article-number":"1891922"}}