Dec 18, 2008

Health - Male circumcision lowers cervical cancer risk: study

Maggie Fox

WASHINGTON (Reuters) – Three studies published on Wednesday add to evidence that circumcision can protect men from the deadly AIDS virus and the sexually transmitted virus that causes cervical cancer.

The reports in the Journal of Infectious Diseases are likely to add to the debate over whether men -- and newborn boys -- should be circumcised to protect their health and perhaps the health of their future sexual partners.

Dr. Bertran Auvert of the University of Versailles in France and colleagues in South Africa tested more than 1,200 men visiting a clinic in South Africa,

They found under 15 percent of the circumcised men and 22 percent of the uncircumcised men were infected with the human papilloma virus, or HPV, which is the main cause of cervical cancer and genital warts.

"This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women," they wrote in their report.

A second paper looking at U.S. men had less clear-cut results, but Carrie Nielson of Oregon Health & Science University and colleagues said they found some indication that circumcision might protect men.

The circumcised men were about half as likely to have HPV as uncircumcised men, after adjustment for other differences between the two groups.


In the third report, Lee Warner of the U.S. Centers for Disease Control and Prevention and colleagues tested African-American men in Baltimore and found 10 percent of those at high risk of infection with HIV who were circumcised had the virus, compared to 22 percent of those who were not.

"Circumcision was associated with substantially reduced HIV risk in patients with known HIV exposure, suggesting that results of other studies demonstrating reduced HIV risk for circumcision among heterosexual men likely can be generalized to the U.S. context," they wrote.

Studies supporting circumcision to reduce HIV transmission had all been done in Africa and U.S. studies were less clear.

Dr. Ronald Gray of Johns Hopkins University in Baltimore and colleagues said they found the reports encouraging.

"In the United States, circumcision is less common among African American and Hispanic men, who are also the subgroups most at risk of HIV," they wrote in a commentary.

"Thus, circumcision may afford an additional means of protection from HIV in these at-risk minorities."

But they noted that the American Academy of Pediatrics does not recommend routine circumcision for newborns.

"As a consequence of this AAP decision, Medicaid does not cover circumcision costs, and this is particularly disadvantageous for poorer African American and Hispanic boys who, as adults, may face high HIV exposure risk," Gray and colleagues wrote.

"It is also noteworthy that circumcision rates have been declining in the U.S., possibly because of lack of Medicaid coverage."

Medicaid is the state-federal health insurance program for the poor and disabled.

Thirty-three million people globally are infected with AIDS, which has no cure and no vaccine. HPV is the most common sexually transmitted infection in the world, with 20 million people in the United States infected. It causes cervical cancer, which kills 300,000 women globally every year.


Caroline said...

There are so many flaws to this I don't know where to begin.

1. The huge majority of HIV infections are from transmissions from man to man, man to woman, and intravenous drug use. Only 11% of transmissions are from woman to man.

2. If you use a condom, circumcision makes no difference. If you do not use a condom, you are still 40-50% likely to contract HIV if you are with an HIV positive person. That's if you only have unprotected sex ONCE. If you have unprotected sex more than once, you are virtually certain to contract HIV regardless of your circumcision status.

3. Promoting circumcision in hopes of preventing HIV transmissions would be a horrific waste of much needed funds. The medical systems in developing countries are already stretched to their limit and often of sub-par quality. Two things have been proven to prevent HIV- condoms, and testing. Most people with HIV do not know they have it. If people will not use condoms or get tested, that is another problem, and needs to be addressed until it is solved.

4. Regarding HPV. It does not "cause" cervical cancer. People who have cervical cancer also have HPV, but many many people live with HPV and never have cervical cancer, genital warts, or any other symptoms.

5. HPV has a vaccine now and is widely available in the US. HPV is also detectable in routine pap smears. It is also the case that a person is more likely to contact HPV the more sexual partners he or she has. There would probably be no way to control for that in a study- participant self-reporting is often not 100% reliable: people lie, don't know, or forget.

6. Lastly, Americans are not leaving their sons intact because of "lack of Medicaid coverage". They are doing so because they are taking the time to research the procedure and decide for themselves, not continuing to circumcise just to fit in or because someone else told them to.

Anonymous said...

Circumcision is bad medical practice, quite simple.

Removing sexual tissue from babies (who are of course not having sex) is not a viable way to go about tackling any sexually-transmitted disease.

This is a throwback to the Victorian age of sexual phobias, of discouraging masturbation and sex in general.

If we wish for the sexual transmission of HIV and other viruses to decrease then education and provision of barrier protection is the answer, NOT dangerous surgery on newborns who have no say in the matter and are not engaging in sexual activity.

We would never justify a reduction in HIV transmission in female-genital-mutilation-practicing populations; sewing women up, removing the clitoris or any part of the external genitalia is likely to a) reduce the number of sexual partners she has (who wants to have sex when it's mainly just painful) and b) perhaps protect her slightly from HIV-contraction as women have the same cell types men do, to which the virus attaches and enters.

FGM is unacceptable because it's dangerous, painful and an horrific act to perform on an unconsenting, unknowing child.

The same goes for MGM.

If we educate our children about sex and STDs then they can make their own decision to have some of their erogenous tissue removed if they so wish. They should also use condoms because as Caroline has said, being circumcised does not REMOVE the risk of HIV transmission. It is ignorance which spreads this virus, not the normal components of the human body alone.

The foreskin has other functions in sex and basic physiology. Men circumcised as adults report loss of sensation; the glans dries up, there is less mobile tissue and this reduces female lubrication during sex.

We are born with our sexual organs as they are for many reasons.

This needs to end now - this is a human rights issue.

Anonymous said...


Why to use a correcting surgery for another extreme anomaly (phimosis),as a preventive of something else that the patient is also not suffering of?
A circumcised man is also a potential patient,regardless of his "lower" chances.Both,circumcised and uncut males need better protection than the reduced advantages that circumcision may dare him.
And still,why to extirpate a healthy foreskin from males who are not otherwise engaged in sexual deviations off marriage?
Is that a preemptive conditioning pro-sex or a punishment discriminated by gender?
Are women more protected by similar surgeries?
To keep producing studies that find secondary uses for circumcisions,in the face of the damages and side effects that trigger on the healthy organ functions of the patients,from infections to other complication risks,is to keep extending the uses of bad quack medicine.
It doesn't prevent blindness anymore.Unless its proponents are deeper in it than others.

enithhernandez said...

I agree with previous commenter. Cutting babies to remove normal and functioning part of their body to 'possible' prevent HIV violates human rights and it is barbaric. The only way to prevent HIV is by using a condom and education.

Robert said...

If someone proposed cutting the genitals of girls in order to protect adult men from a sexually transmitted disease like HPV, most people would be outraged. Why does our society tolerate the double standard? Why we are not outraged when someone proposes cutting the genitals of boys in order to protect adult women from a sexually transmitted disease?