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Male circumcision tied to lower cervical Ca risk. (Lower Risk of HPV Infection in Men).

Circumcision may reduce men's risk of penile human papillomavirus infection and moderately decrease their female partners' chances of developing cervical cancer, according to a recent study

The findings suggest that circumcision is an important cofactor in human papillomavirus (HPV) infection and cervical cancer, reported Dr. Xavier Castellsague of the Catalan Institute of Oncology, Barcelona, Spain, and his associates in the International Agency for Research on Cancer Multicenter Cervical Cancer Study Group.

Of 847 uncircumcised men, 166 (19.6%) had HPV infection, compared with 16 of 292 (5.5%) circumcised men, a statistically significant difference. Men with self-reported circumcision had an adjusted risk ratio for penile HPV infection of 0.37; the adjusted risk ratio among those with clinician-assessed circumcision was 0.44.

Having six or more sexual partners was significantly associated with increased rates of penile HPV. Men who had had at least six sexual partners were twice as likely to be infected as were men with fewer partners.

Removal of the foreskin and its relatively vulnerable mucosal inner lining may play a role in keeping HPV infection rates lower among circumcised men, the researchers suggested (N. Engl. J. Med. 346[15]:1 105-12, 2002).

Women with circumcised partners were somewhat less likely than women with uncircumcised partners .to develop cervical cancer, although the odds ratio of 0.72 was not statistically significant.

The investigators pooled data on 2,800 women diagnosed with invasive cervical cancer or cervical carcinoma in situ in seven case-control studies in five countries.

The study included data on 1,139 of the women's husbands or stable partners; a stable partner was a man with whom the woman had had regular intercourse for at least 6 months of the study.

In an accompanying editorial, Dr. HansOlov Adami of the Karolinska Institute, Stockholm, and Dr. Dimitrios Trichopoulos of the Harvard School of Public Health, Boston, emphasized that circumcision alone does not protect against cervical cancer(N. Engl. J. Med. 346[15]:1160-61, 2002).

The procedure is instead a modifying factor that can reduce the prevalence of cervical cancer's principal cause: HPV infection. But the general adoption of circumcision-based on the findings in the study and the assumption that 25% of men worldwide are already circumcised-might reduce the incidence of cervical cancer by 23%-43%, they suggested.
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Author:Rudd, Terry
Publication:OB GYN News
Date:Jun 1, 2002
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