Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners

Xavier Castellsagué, F. Xavier Bosch, Nubia Muñoz, Chris J L M Meijer, Keerti V. Shah, Silvia De Sanjosé, José Eluf-Neto, Corazon A. Ngelangel, Saibua Chichareon, Jennifer S. Smith, Rolando Herrero, Victor Moreno, Silvia Franceschi

Research output: Contribution to journalArticle

Abstract

Background: It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. Methods: We pooled data on 1913 couples enrolled in one of seven case-control studies of cervical carcinoma in situ and cervical cancer in five countries. Circumcision status was self-reported, and the accuracy of the data was confirmed by physical examination at three study sites. The presence or absence of penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1520 men and yielded a valid result in the case of 1139 men (74.9 percent). Results: Penile HPV was detected in 166 of the 847 uncircumcised men (19.6 percent) and in 16 of the 292 circumcised men (5.5 percent). After adjustment for age at first intercourse, lifetime number of sexual partners, and other potential confounders, circumcised men were less likely than uncircumcised men to have HPV infection (odds ratio, 0.37; 95 percent confidence interval, 0.16 to 0.85). Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised (adjusted odds ratio, 0.42; 95 percent confidence interval, 0.23 to 0.79). Results were similar in the subgroup of men in whom circumcision was confirmed by medical examination. Conclusions: Male circumcision is associated with a reduced risk of penile HPV infection and, in the case of men with a history of multiple sexual partners, a reduced risk of cervical cancer in their current female partners.

Original languageEnglish (US)
Pages (from-to)1105-1112
Number of pages8
JournalNew England Journal of Medicine
Volume346
Issue number15
DOIs
StatePublished - Apr 11 2002

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Male Circumcision
Papillomavirus Infections
Uterine Cervical Neoplasms
Sexual Partners
Odds Ratio
Confidence Intervals
Coitus
Carcinoma in Situ
Physical Examination
Case-Control Studies
Polymerase Chain Reaction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Castellsagué, X., Bosch, F. X., Muñoz, N., Meijer, C. J. L. M., Shah, K. V., De Sanjosé, S., ... Franceschi, S. (2002). Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. New England Journal of Medicine, 346(15), 1105-1112. https://doi.org/10.1056/NEJMoa011688

Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. / Castellsagué, Xavier; Bosch, F. Xavier; Muñoz, Nubia; Meijer, Chris J L M; Shah, Keerti V.; De Sanjosé, Silvia; Eluf-Neto, José; Ngelangel, Corazon A.; Chichareon, Saibua; Smith, Jennifer S.; Herrero, Rolando; Moreno, Victor; Franceschi, Silvia.

In: New England Journal of Medicine, Vol. 346, No. 15, 11.04.2002, p. 1105-1112.

Research output: Contribution to journalArticle

Castellsagué, X, Bosch, FX, Muñoz, N, Meijer, CJLM, Shah, KV, De Sanjosé, S, Eluf-Neto, J, Ngelangel, CA, Chichareon, S, Smith, JS, Herrero, R, Moreno, V & Franceschi, S 2002, 'Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners', New England Journal of Medicine, vol. 346, no. 15, pp. 1105-1112. https://doi.org/10.1056/NEJMoa011688
Castellsagué X, Bosch FX, Muñoz N, Meijer CJLM, Shah KV, De Sanjosé S et al. Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. New England Journal of Medicine. 2002 Apr 11;346(15):1105-1112. https://doi.org/10.1056/NEJMoa011688
Castellsagué, Xavier ; Bosch, F. Xavier ; Muñoz, Nubia ; Meijer, Chris J L M ; Shah, Keerti V. ; De Sanjosé, Silvia ; Eluf-Neto, José ; Ngelangel, Corazon A. ; Chichareon, Saibua ; Smith, Jennifer S. ; Herrero, Rolando ; Moreno, Victor ; Franceschi, Silvia. / Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners. In: New England Journal of Medicine. 2002 ; Vol. 346, No. 15. pp. 1105-1112.
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abstract = "Background: It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. Methods: We pooled data on 1913 couples enrolled in one of seven case-control studies of cervical carcinoma in situ and cervical cancer in five countries. Circumcision status was self-reported, and the accuracy of the data was confirmed by physical examination at three study sites. The presence or absence of penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1520 men and yielded a valid result in the case of 1139 men (74.9 percent). Results: Penile HPV was detected in 166 of the 847 uncircumcised men (19.6 percent) and in 16 of the 292 circumcised men (5.5 percent). After adjustment for age at first intercourse, lifetime number of sexual partners, and other potential confounders, circumcised men were less likely than uncircumcised men to have HPV infection (odds ratio, 0.37; 95 percent confidence interval, 0.16 to 0.85). Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised (adjusted odds ratio, 0.42; 95 percent confidence interval, 0.23 to 0.79). Results were similar in the subgroup of men in whom circumcision was confirmed by medical examination. Conclusions: Male circumcision is associated with a reduced risk of penile HPV infection and, in the case of men with a history of multiple sexual partners, a reduced risk of cervical cancer in their current female partners.",
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T1 - Male circumcision, penile human papillomavirus infection, and cervical cancer in female partners

AU - Castellsagué, Xavier

AU - Bosch, F. Xavier

AU - Muñoz, Nubia

AU - Meijer, Chris J L M

AU - Shah, Keerti V.

AU - De Sanjosé, Silvia

AU - Eluf-Neto, José

AU - Ngelangel, Corazon A.

AU - Chichareon, Saibua

AU - Smith, Jennifer S.

AU - Herrero, Rolando

AU - Moreno, Victor

AU - Franceschi, Silvia

PY - 2002/4/11

Y1 - 2002/4/11

N2 - Background: It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. Methods: We pooled data on 1913 couples enrolled in one of seven case-control studies of cervical carcinoma in situ and cervical cancer in five countries. Circumcision status was self-reported, and the accuracy of the data was confirmed by physical examination at three study sites. The presence or absence of penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1520 men and yielded a valid result in the case of 1139 men (74.9 percent). Results: Penile HPV was detected in 166 of the 847 uncircumcised men (19.6 percent) and in 16 of the 292 circumcised men (5.5 percent). After adjustment for age at first intercourse, lifetime number of sexual partners, and other potential confounders, circumcised men were less likely than uncircumcised men to have HPV infection (odds ratio, 0.37; 95 percent confidence interval, 0.16 to 0.85). Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised (adjusted odds ratio, 0.42; 95 percent confidence interval, 0.23 to 0.79). Results were similar in the subgroup of men in whom circumcision was confirmed by medical examination. Conclusions: Male circumcision is associated with a reduced risk of penile HPV infection and, in the case of men with a history of multiple sexual partners, a reduced risk of cervical cancer in their current female partners.

AB - Background: It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. Methods: We pooled data on 1913 couples enrolled in one of seven case-control studies of cervical carcinoma in situ and cervical cancer in five countries. Circumcision status was self-reported, and the accuracy of the data was confirmed by physical examination at three study sites. The presence or absence of penile HPV DNA was assessed by a polymerase-chain-reaction assay in 1520 men and yielded a valid result in the case of 1139 men (74.9 percent). Results: Penile HPV was detected in 166 of the 847 uncircumcised men (19.6 percent) and in 16 of the 292 circumcised men (5.5 percent). After adjustment for age at first intercourse, lifetime number of sexual partners, and other potential confounders, circumcised men were less likely than uncircumcised men to have HPV infection (odds ratio, 0.37; 95 percent confidence interval, 0.16 to 0.85). Monogamous women whose male partners had six or more sexual partners and were circumcised had a lower risk of cervical cancer than women whose partners were uncircumcised (adjusted odds ratio, 0.42; 95 percent confidence interval, 0.23 to 0.79). Results were similar in the subgroup of men in whom circumcision was confirmed by medical examination. Conclusions: Male circumcision is associated with a reduced risk of penile HPV infection and, in the case of men with a history of multiple sexual partners, a reduced risk of cervical cancer in their current female partners.

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