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Previous Volume 346:1105-1112 April 11, 2002 Number 15 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Editorial by Adami, H.-O. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

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.

Source Information

From the Servei d'Epidemiologia i Registre del Càncer, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain (X.C., F.X.B., S.S.); the International Agency for Research on Cancer, Lyons, France (N.M., J.S.S., R.H., S.F.); Free University Hospital, Amsterdam (C.J.L.M.M.); Johns Hopkins University, Baltimore (K.V.S.); Universidade de São Paulo, São Paulo, Brazil (J.E.-N.); Philippine General Hospital, University of the Philippines, Manila, the Philippines (C.A.N.); the Faculty of Medicine, Prince of Songkla University, Hat-Yai, Thailand (S.C.); and Proyecto Epidemiológico Guanacaste, San José, Costa Rica (R.H.).

Victor Moreno, M.D., Servei d'Epidemiologia i Registre del Càncer, Institut Català d'Oncologia, Hospitalet de Llobregat, Barcelona, Spain, was also an author.

Address reprint requests to Dr. Castellsagué at the Servei d'Epidemiologia i Registre del Càncer, Institut Català d'Oncologia, Gran Via s/n, Km 2.7, 08907 Hospitalet de Llobregat, Barcelona, Spain, or at xcastellsague{at}ico.scs.es.

Full Text of this Article

Related Letters:

Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer
Travis J. W., Bhimji A., Harrison D., Castellsagué X., Bosch F. X., Muñoz N.
Extract | Full Text | PDF  
N Engl J Med 2002; 347:1452-1453, Oct 31, 2002. Correspondence

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