Circumcision 'curbs cervical cancer risk'

BBC Health, April 10, 2002

Women who have sex with a circumcised man have lower rates of cervical cancer, scientists have found.

They also suggest men themselves are less likely to develop genital warts.

In a study in the New England Journal of Medicine, they suggest the health benefits could be because circumcised men are less likely to pick up the human papillomavirus (HPV.

They suggest the virus is responsible for up to 99% of cases of cervical cancer.

Commentators suggest that a general adoption of circumcision could cut cervical cancer rates by 20%. The general adoption of circumcision might lead to a further reduction in the incidence of cancer of the cervix of 23% to 43% They add the risk of penile cancer, HIV and other infections could also be reduced.

Regular condom use and proper hygiene were also ways infection risks could be reduced, they said.

An HPV vaccine is also now being tested.

Previous research has also found uncircumcised men are at a much greater risk of becoming infected with HIV from heterosexual sex than circumcised men.

Cervical cancer killed around 1,250 UK women in 2000.

'Plausible explanation'

The researchers, led by Dr Xavier Castellsague of Llobregat Hospital in Barcelona looked at data from seven studies from five countries across the world.

They found HPV in nearly 20% of uncircumcised men, but in fewer than 6% of all circumcised men.

The researchers estimate that a woman's chance of developing cervical cancer was at least 58% lower if their current partner was circumcised, even if the partner had a history of multiple partners.

Writing in an editorial in the journal, Dr Hans-Olov Adami of the Karolinska Institute in Stockholm and Dr Dimitrios Trichopoulos of the Harvard School of Public Health said the idea "that circumcision may reduce the risk of cervical cancer in the female partner has long been suspected".

They said the new study "provides a biologically plausible explanation."

They added: "If we assume that 25% of the men around the world are circumcised, then the general adoption of circumcision might lead to a further reduction in the incidence of cancer of the cervix of 23% to 43%".

But they admitted that advocating circumcision as a realistic and significantly important addition to other strategies to combat cervical cancer "remains to be documented".

But Cancer Research UK advises it had been thought women whose partners were circumcised were less likely to get cervical cancer because the secretions of the foreskin covering the penis in uncircumcised men may be irritant to the cervix and so possibly a factor in cervical cancer.

But it adds many now thought that as long as uncircumcised men are careful about keeping their genitals clean, the risk of cervical cancer in their partners should not be any greater than that for circumcised men.

Cancer Research UK adds: "It is likely that this association has risen because certain religious groups who practice circumcision, such as the Jews, also have a low risk of cervical cancer due to low levels of promiscuity."