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Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners.

Abstract

BACKGROUND

It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner.

METHODS

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.

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  • Authors+Show Affiliations

    ,

    Servei d'Epidemiologia i Registre del Càncer, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain. xcastellsague@ico.scs.es

    , , , , , , , , , , , ,

    Source

    The New England journal of medicine 346:15 2002 Apr 11 pg 1105-12

    MeSH

    Adult
    Carcinoma in Situ
    Case-Control Studies
    Circumcision, Male
    DNA, Viral
    Female
    Genital Diseases, Male
    Humans
    Logistic Models
    Male
    Middle Aged
    Odds Ratio
    Papillomaviridae
    Papillomavirus Infections
    Risk Factors
    Sexual Behavior
    Sexual Partners
    Tumor Virus Infections
    Uterine Cervical Neoplasms

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11948269

    Citation

    Castellsagué, Xavier, et al. "Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer in Female Partners." The New England Journal of Medicine, vol. 346, no. 15, 2002, pp. 1105-12.
    Castellsagué X, Bosch FX, Muñoz N, et al. Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med. 2002;346(15):1105-12.
    Castellsagué, X., Bosch, F. X., Muñoz, N., Meijer, C. J., Shah, K. V., de Sanjose, S., ... Franceschi, S. (2002). Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. The New England Journal of Medicine, 346(15), pp. 1105-12.
    Castellsagué X, et al. Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer in Female Partners. N Engl J Med. 2002 Apr 11;346(15):1105-12. PubMed PMID: 11948269.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. AU - Castellsagué,Xavier, AU - Bosch,F Xavier, AU - Muñoz,Nubia, AU - Meijer,Chris J L M, AU - Shah,Keerti V, AU - de Sanjose,Silvia, AU - Eluf-Neto,José, AU - Ngelangel,Corazon A, AU - Chichareon,Saibua, AU - Smith,Jennifer S, AU - Herrero,Rolando, AU - Moreno,Victor, AU - Franceschi,Silvia, AU - ,, PY - 2002/4/12/pubmed PY - 2002/4/17/medline PY - 2002/4/12/entrez SP - 1105 EP - 12 JF - The New England journal of medicine JO - N. Engl. J. Med. VL - 346 IS - 15 N2 - BACKGROUND: It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. METHODS: 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. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/11948269/full_citation L2 - https://www.nejm.org/doi/10.1056/NEJMoa011688?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=www.ncbi.nlm.nih.gov DB - PRIME DP - Unbound Medicine ER -