Circumcision lowers risk of cervical cancer

By Rita Rubin, USA TODAY

Women whose sexual partners are circumcised are less likely to develop cervical cancer than the partners of uncircumcised men, concludes a report out today.

The difference was statistically significant only in the partners of men considered to be at high risk for infection with human papillomavirus, or HPV, according to the study in The New England Journal of Medicine. Such men had had at least six sexual partners in their lifetime, beginning before age 17.

HPV causes genital warts in men and women, and certain strains cause virtually all cervical cancers. HPV also has been linked to cancers of the vagina, anus and penis.

The new report is based on 1,913 couples in five countries. All were married or in a stable relationship for at least six months. Half of the women had cervical cancer, and 370 of the men were circumcised. Worldwide, an estimated one in four men are circumcised.

Researchers interviewed all of the men and got samples of penile cells from 1,524. The scientists tested the samples for HPV.

After accounting for such factors as age at first intercourse and lifetime number of sexual partners, circumcised men were only about a third as likely as uncircumcised men to test positive for HPV. The authors speculate that circumcision, which involves removal of the foreskin, minimizes the area of the penis vulnerable to HPV infection.

On the whole, partners of circumcised men were about 25% less likely to have cervical cancer than partners of uncircumcised men, a difference that was not statistically significant. But among women in relationships with men at high risk for HPV, those with circumcised partners were 80% less likely to have cervical cancer.

Co-author Keerti Shah, a virologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore, notes that other research suggests that circumcision also reduces men's risk of infection with HIV, the virus that causes AIDS.

"This may be something that may be true for many sexually transmitted infections," Shah says.

He and his co-authors write that more research is needed to determine whether routine circumcision could reduce the risks of HIV, HPV and other sexually transmitted diseases.

In 1999, an American Academy of Pediatrics task force concluded that the medical benefits "are not sufficient to recommend routine neonatal circumcision."

From 1979 to 1999, the proportion of circumcised U.S. newborns remained around 65%.

Anti-circumcision groups argue that the procedure causes unnecessary pain in newborns and adversely affects men's sexual sensations.