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Male Circumcision and Female Cervical Cancer

Circumcision not only protects against HPV infection and HIV infection, but it may decrease the incidence of cervical cancer as well.

About 25% of men are circumcised worldwide. This procedure substantially reduces the risk for urinary tract infections, penile cancer, and HIV infection. These authors pooled data from case-control studies in 5 countries (Spain, Colombia, Brazil, Thailand, and the Philippines) to assess the influence of circumcision on the frequency of human papillomavirus (HPV) infection in men and on cervical cancer in their sexual partners. Investigators examined women with newly diagnosed cervical carcinoma and their stable male sexual partners (i.e., men with whom the women had had regular sexual intercourse for at least 6 months). They tested the men for HPV infection by polymerase chain reaction assay.

HPV was present in 19.6% of uncircumcised men and 5.5% of circumcised men. Men who had had 6 or more sexual partners also had an increased risk for infection. After adjustment for confounding variables, circumcision remained associated with less frequent HPV infection. Monogamous women whose male partners had had 6 lifetime sexual partners were more likely to have cervical cancer if their partner was uncircumcised.

Comment: This epidemiologic study demonstrates that circumcision protects against HPV infection in men and reduces the risk for cervical cancer in the stable female partners of men with 6 or more previous partners. Circumcision probably protects against HPV infection by removing the substantial and relatively delicate surface area of the prepuce, which is more vulnerable to invasion by HPV than the tougher glans. More widespread circumcision might not only significantly reduce the incidence of HIV and HPV infections but that of cervical cancer as well.

— Jan V. Hirschmann, MD

Published in Journal Watch Dermatology May 14, 2002

Citation(s):

Castellsagué X et al. Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med 2002 Apr 11; 346:1105-12.

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