Male circumcision and HPV transmission to female partners

Abstract

Male circumcision has been done for many years as a religious tradition, and since the 19th century has been thought to confer protection against sexually transmitted infections and diseases such as cervical cancer. In 1901, Braithwaite 1 Braithwaite J Excess of salt in the diet a probable factor in the causation of cancer. Lancet. 1901; 158: 1578-1580 Abstract Scopus (6) Google Scholar commented on the low incidence of cervical cancer in Jewish women—women who were married to circumcised men. Boyd and Doll later noted that cervical cancer is rare in communities in which men are circumcised. 2 Boyd JT Doll R A study of the aetiology of carcinoma of the cervix uteri. Br J Cancer. 1964; 13: 419-434 Crossref PubMed Scopus (99) Google Scholar With the recognition that human papillomavirus (HPV) is causative in the development of cervical cancer, and with advances in methodology for the detection of HPV, further studies have supported these early observations that circumcision protects against HPV infection and cervical cancer in female partners. 3 Castellsagué X Bosch FX Muñoz N et al. for the International Agency for Research on Cancer Multicenter Cervical Cancer Study GroupMale circumcision, penile human papillomavirus infection, and cervical cancer in female partners. N Engl J Med. 2002; 346: 1105-1112 Crossref PubMed Scopus (589) Google Scholar , 4 Tobian AA Serwadda D Quinn TC et al. Male circumcision for the prevention of HSV-2 and HPV infections and syphilis. N Engl J Med. 2009; 360: 1298-1309 Crossref PubMed Scopus (377) Google Scholar , 5 Auvert B Sobngwi-Tambekou J Cutler E et al. Effect of male circumcision on the prevalence of high-risk human papillomavirus in young men: results of a randomized controlled trial conducted in Orange Farm, South Africa. J Infect Dis. 2009; 199: 14-19 Crossref PubMed Scopus (209) Google Scholar Effect of circumcision of HIV-negative men on transmission of human papillomavirus to HIV-negative women: a randomised trial in Rakai, UgandaOur findings indicate that male circumcision should now be accepted as an efficacious intervention for reducing the prevalence and incidence of HPV infections in female partners. However, protection is only partial; the promotion of safe sex practices is also important. Full-Text PDF