Circumcised men at equal risk of HPV infection

A large-scale study at the University of Washington has found no difference in the incidence of HPV infection between circumcised and uncircumcised male college students. HPV (Human Papilloma Virus) is a large group of viruses that may cause genital warts, and are implicated in the genesis of genital cancers. HPV is very common among the sexually active population. but most people never show any symptoms. The risk factors for the development of cancer have been shown to be numerous different sexual partners and smoking. The new study confirmed previous research which showed that the location of the virus differed between circumcised and uncircumcised men: circumcised men tend to carry the virus on the shaft skin of the penis, while intact men are more likely to carry it on the glans. The study also also found that circumcised men have more sexual partners. In a previous study the researchers found found that for college females the circumcision status of their partner was NOT a risk factor for HPV infection in women. The authors comment that the African Random Clinical Trials, which seemed to show that uncircumcised men were more likely to carry the HPV virus, were seriously flawed because they took samples only from the glans (not from the shaft skin, where the virus is concentrated in the circumcised).

ABSTRACT

Background: The role of circumcision in male HPV acquisition is not clear.

Methods: Male university students (aged 18–20 years) were recruited from 2003 to 2009 and followed up triannually. Shaft/scrotum, glans, and urine samples were tested for 37 human papillomavirus (HPV) genotypes. Cox proportional hazards methods were used to evaluate the association between circumcision and HPV acquisition. Logistic regression was used to assess whether the number of genital sites infected at incident HPV detection or site of incident detection varied by circumcision status.

Results: In 477 men, rates of acquiring clinically relevant HPV types (high-risk types plus types 6 and 11) did not differ significantly by circumcision status (hazard ratio for uncircumcised relative to circumcised subjects: 0.9 [95% confidence interval{CI}: 0.7–1.2]). However, compared with circumcised men, uncircumcised men were 10.1 (95% CI: 2.9 –35.6) times more likely to have the same HPV type detected in all 3 genital specimens than in a single genital specimen and were 2.7 (95% CI: 1.6–4.5) times more likely to have an HPV-positive urine or glans specimen at first detection.

Conclusion: We found no differences by circumcision status in overall HPV acquisition or in number of HPV types acquired. Findings held for all clinically relevant HPV types, as well as for the subgroups of high-risk types, high-risk -9 types, and HPV-16. This observation is consistent with findings from other longitudinal studies.

Bottom line: Circumcision does not lower the risk of infection with Human Papilloma Virus. People who claim that uncircumcised men are more likely to develop or communicate genital cancers are ignoring the facts and spreading misleading information.

Source:  Kelley Van Buskirk et al, Circumcision and Acquisition of Human Papillomavirus Infection in Young Men, Sexually Transmitted Diseases 38 (12), December 2011.

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Circumcision, human papilloma virus (HPV) and cervical cancer in women

A review (2015) of the literature by a statistical and epidemiological experts shows there is no evidence that uncircumcised men are more likely to harbour HPV.

Abstract: Genital infections with human papillomavirus (HPV) may be the most common sexually transmitted infections, but most infections with HPV are transient. While HPV infections may cause cervical cancer, only a handful of the hundred or so types of HPV are carcinogenic. Some have claimed, using a selective bibliography, that circumcision in males reduces the risk of HPV infections and the risk of cervical cancer in female sexual partners. The breadth and the quality of the epidemiological research regarding any association between male circumcision and HPV infections in general, and carcinogenic HPV in particular, will be considered. It will also be explored whether associations found in some studies can be attributed to other factors.

Conclusion: The big lie To get to the truth, one needs to look beyond just the tip of the penis to get the full picture of the impact of circumcision on the risk for genital HPV infections. For all the hyperbole surrounding the propaganda of repeating the lie that circumcision reduces the risk of genital HPV infections in both men and women, the medical evidence simply does not support this claim. Anyone who makes these claims should be called out as a fraud.

Source:  Dr Robert Van Howe. Human Papillomavirus and Circumcision: The Story Beyond the Tip