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Circumcision and HPV Infection
Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer in Female Partners. Castellsagué X, Bosch X, Muñoz N, et al. New Engl J Med
(April 11, 2002); 346:1105-12.This study was done to determine whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. We pooled data on 1913 couples enrolled in one of seven case–control studies of cervical carcinoma in situ and cervical cancer in five countries. Circumcision status was self-reported, and the accuracy of the data was confirmed by physical examination at three study sites. The presence or absence of penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1520 men and yielded a valid result in the case of 1139 men (74.9 percent).
Results. Penile HPV was detected in 166 of the 847 uncircumcised men (19.6 percent) and in 16 of the 292 circumcised men (5.5 percent). After adjustment for age at first intercourse, lifetime number of sexual partners, and other potential confounders, circumcised men were less likely than uncircumcised men to have HPV infection (odds ratio, 0.37; 95 percent confidence interval, 0.16 to 0.85). Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised (adjusted odds ratio, 0.42; 95 percent confidence interval, 0.23 to 0.79). Results were similar in the subgroup of men in whom circumcision was confirmed by medical examination.
Conclusions. Male circumcision is associated with a reduced risk of penile HPV infection and, in the case of men with a history of multiple sexual partners, a reduced risk of cervical cancer in their current female partners.
Comment. The Great Circumcision Debate continues. Score one point for the pro-circumcision folks. The data are convincing. Circumcised men have a much lower risk of acquiring HPV infection. HPV causes genital warts in men and women, and has been linked to a wide variety of genital cancers. Cervical cancer is the second most common cancer among women, and up to 99% of cervical cancers are associated with HPV infection. So girls, beware of uncircumcised men who have had 6 or more sexual partners. ABK
Additional Comments:
Date: 13 May 2002
Time: 17:50:46
After following this debate for years I wonder how many forests have been sacrificed.
For reasons that elude me, this subject always raises very emotional and vocal
debates in all venues in which it is discussed. Suffice it to say that supporters of
each side of the debate make convincing arguments to support their agenda - enough I say -
enough trees, enough ink, enough cyberspace. Please, oh please I beg of you - let
people make their own informed choice and be done with it. Surely there are way more
important issues in the world of neonatology to explore.
Thanks for letting me vent.
Steven Benn
Rapid City Regional Hospital
telephone: 605 719-8333
email: neodoc@rapidnet.com
Date: 22 Dec 2002
Time: 00:52:34
Now that circumcision is done to prevent future cancer (which is the worrisome
thing about HPV anyway) let us start doing mastectomies in female newborns. It
should be an easy, simple procedure, done with local anesthesia, and the
patients "will not remember it."
UserName: Raul Cuestas, MD, PhD, FAAP
Institution: Consultorios Royal Center, Panama
telephone: 507-315-1489
email:
raulcuestas@yahoo.es
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