FINDINGS

Thursday, April 11, 2002; Page A14

Circumcision a Factor

In Cervical Cancer

Women whose sex partners are circumcised may be less likely to get cervical cancer, a study suggests.

Cervical cancer is caused by the same virus responsible for genital warts.

The study in today's New England Journal of Medicine found that men with intact foreskins were three times as likely as circumcised men to be infected with the human papillomavirus. That, in turn, may increase the risk of passing the virus on to their sex partners.

The theory is that the skin in the inner lining of the foreskin is especially vulnerable to the virus.

"It will certainly fuel the ongoing debate about the merits of circumcision," said Michael Thun, an American Cancer Society epidemiologist not involved in the study. He said it raises the question of whether circumcision can reduce the spread of the AIDS virus, too.

The cervical cancer study, conducted by researchers in Spain and four other countries, looked at nearly 3,800 women, half of whom had cervical cancer, half of whom were cancer-free.

There was only a slight overall difference between the two groups in how many had circumcised partners and how many had uncircumcised ones. But the researchers found a strong difference in the risk of cervical cancer when it came to women whose partners were especially active sexually. Women whose high-risk partners were not circumcised were five times as likely to get cancer as those whose partners were circumcised.

Experience Decreases

Risks of Surgery

Whether it's high-risk surgery or a more ordinary operation, experience counts.

Two studies in today's New England Journal of Medicine looked at how patients fared after operations. The findings add to the evidence that people should look for experienced surgeons and hospital staffs.

One study looked at 14 high-risk cardiovascular or cancer operations on 2.5 million patients between 1994 and 1999. The other studied 11,522 men whose prostates were removed between 1992 and 1996 because of cancer.

Prostate removal has a very low risk of death but can have life-threatening complications and can leave men with bladder obstructions, incontinence and other urinary problems, or impotence.

The study did not look at impotence. But Peter Scardino of Memorial Sloan-Kettering Cancer Center's urology department in New York found that the other dangers are less likely if the operation is done either at a hospital where many prostatectomies are performed or by a surgeon who does the operation often.

Experience can avert post-operative complications for about five of every 100 patients and urinary side effects for eight out of every 100, Scardino said.

The larger study, led by John D. Birkmeyer of Dartmouth Medical School's surgery department, found that patients were more likely to survive a specific operation at hospitals where that operation was performed often.

-- Compiled from reports by the Associated Press