A recent study in the International Journal of Cancer looked at whether circumcision lowers the risk of flat penile lesions associated with precancerous and cancerous penile lesions in men. This study was actually part of a bigger study that primarily looked at whether circumcision made a difference in the transmission of HIV disease among men in Africa.
Researchers at UNC Chapel Hill looked at the connection of circumcision to human papillomavirus-associated precancerous lesions of the penis. What they found was dramatic: the rate of flat penile lesions was significantlylower in those men who had been circumcised. The percentage with these lesions that were not circumcised was 26%, as compared to less than 1% in those who were circumcised. That’s a clinical as well as statistically significant difference. The authors also noted that these same flat lesions had a strong association with DNA associated with high risk human papillomavirus, the virus associated with penile cancer in men and cervical cancer in women.
This research adds to other reports that shows male circumcision can dramatically reduce risks of male genital human papillomavirus infection, penile cancer and even HIV infection. In 1999, in the Journal Pediatrics, research showed that newborn circumcision was highly protective against invasive penile cancer. A randomized controlled trial by RTI researchers, published in Lancet in 2007, showed a 60% reduction in HIV transmission among circumcised men in Africa compared to those not circumcised. Review of this data and two other randomized controlled trials was published in 2008 in the International Journal AIDS. They reported that three randomized controlled trial of circumcision among consenting, healthy adult men in Uganda, Kenya and South Africa were all halted early after recommendations by independent Data and Safety Monitoring Boards, as analyses found a highly reduced risk of HIV among the men randomly assigned to circumcision compared to those who did not receive the procedure. A large systematic review published this year in the Journal of Infectious Disease, reached similar conclusions.
It’s important as we look at such health data to remember that parental decisions to circumcise a newborn male child are intimately tied not only health outcomes but frequently to religious and cultural beliefs. Most of the studies cited above were looking at adult men in areas where a much higher prevalence of HPV and HIV infection exists. Penile cancer is also rarer compared to most other cancer types. Yet, we feel it is important for parents to have access to health information that may help them decide what is right for them and their child when they have health questions about circumcision.