Effect of male circumcision on the prevalence of high-risk human papillomavirus in young men: results of a randomized controlled trial conducted in Orange Farm, South Africa.
Open accessAbstract
BACKGROUND: A causal association links high-risk human papillomavirus (HR-HPV) and cervical cancer, which is a major public health problem. The objective of the present study was to investigate the association between male circumcision (MC) and the prevalence of HR-HPV among young men. METHODS: We used data from a MC trial conducted in Orange Farm, South Africa, among men aged 18-24 years. Urethral swab samples were collected during a period of 262 consecutive days from participants in the intervention (circumcised) and control (uncircumcised) groups who were reporting for a scheduled follow-up visit. Swab samples were analyzed using polymerase chain reaction. HR-HPV prevalence rate ratios (PRRs) were assessed using univariate and multivariate log Poisson regression. RESULTS: In an intention-to-treat analysis, the prevalences of HR-HPV among the intervention and control groups were 14.8% (94/637) and 22.3% (140/627), respectively, with a PRR of 0.66 (0.51-0.86) (P = .002). Controlling for propensity score and confounders (ethnic group, age, education, sexual behavior [including condom use], marital status, and human immunodeficiency virus status) had no effect on the results. CONCLUSIONS: This is the first randomized controlled trial to show a reduction in the prevalence of urethral HR-HPV infection after MC. This finding explains why women with circumcised partners are at a lower risk of cervical cancer than other women.
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Male circumcision is highly protective against urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections, and urogenital cancers.
“Male circumcision is a highly effective medical procedure that is protective against various medical conditions including urinary tract infections, inflammatory conditions of the penis, sexually transmitted infections—such as those caused by human papillomaviruses, herpes simplex virus type 2, and human immunodeficiency virus (HIV)—and urogenital cancers.1-7”
From Rapid Training and Implementation of the Pollock Technique, a Safe, Effective Newborn Circumcision Procedure, in a Low-Resource Setting (2015) · cites this paper as [2]
The Results and Conclusions (p. 1) report lower urethral high-risk HPV prevalence among circumcised young men, and the introduction (p. 1) describes a partial protective effect against HIV. This paper does not establish protection against urinary tract infections, penile inflammatory conditions, HSV-2, or urogenital cancers; its cancer discussion concerns the implications of reduced HPV infection. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn those trials, circumcision also was protective against other STIs, including high-risk genital HPV infection and genital herpes.
“In those trials, circumcision also was protective against other STIs, including high-risk genital HPV infection and genital herpes (66–68).”
From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [67]
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Background
- Authors
- Auvert, B., Sobngwi-Tambekou, J., Cutler, E., Nieuwoudt, M., Lissouba, P., Puren, A., & Taljaard, D.
- Affiliations
- Inserm (FR)
- National Institute for Communicable Diseases (ZA)
- Corresponding author
- Auvert, Bertran
- Venue
- Journal of Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2009-01-01
- Volume
- 199
- Issue
- 1
- Pages
- 14-19
- ISSN
- 0022-1899 (ISSN-L)
- 1537-6613
- PMC
- PMC2821597
- OpenAlex
- W2132386620
- Cited by
- 285
- References
- 24
- Citations by year
- 2025: 4 · 2024: 5 · 2023: 3 · 2022: 9 · 2021: 6 · 2020: 5 · 2019: 15 · 2018: 7 · 2017: 21 · 2016: 15 · 2015: 17 · 2014: 28 · 2013: 28 · 2012: 34
- FWCI
- 30.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The Journal of Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- HAL (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Surgery › Genital Health and Disease
- Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
- Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
- Keywords
- male circumcision, high-risk HPV, HPV prevalence, young men, cervical cancer prevention, sexually transmitted infections, condom use, HIV status
- MeSH terms
- Adolescent, Circumcision, Male, Gonorrhea, Humans, Male, Neisseria gonorrhoeae, Risk Factors, Sexual Behavior, South Africa, Urethra, HIV Infections, Prevalence, Risk Assessment, Papillomavirus Infections, Young Adult
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