Saturday, January 8, 2011

Circumcision Cuts HPV, Cervical Cancer Risk

Circumcision significantly decreases the incidence and transmission rate of the Human Papilloma Virus (HPV), according to a new study.

HPV is probably the most common Sexually Transmitted Disease (STD) in existence, before Herpes (HSV), and is commonly assumed to be present in 1/4 to 3/4 of sexually active adults in the US. Some variants of HPV are the primary cause of cervical cancer, while others are associated with anal, penile, head and neck cancers, and with genital warts. Cervical cancer is the second most common form of cancer among women, and a vaccine now exists to be given to pre-sexually active teens. While many HPV infections eventually resolve themselves, HPV is considered incurable. Because of the remarkable prevalence of HPV, impact on its transmission rate is of particular interest. A new study shows very significant results.

The study, published in the prestigious UK Journal The Lancet this week by researchers from Johns Hopkins University, set up two randomized controlled trials (the highest standard for proof of causality), tracking nearly 1,000 couples in Uganda, over a two-year period. The incidence of new HPV infections was 28% lower for women with circumcised partners compared to those with uncircumcised partners. Previous research has shown 32 to 35% decrease of HPV transmission rates to circumcised male partners, compared to uncircumcised male partners. The results of these studies reinforce those obtained in observational studies in the US.

"Male circumcision has now been shown to decrease HIV, herpes simplex virus-2, and HPV infections and genital ulcer disease in men, and also HPV infection, trichomoniasis, and bacterial vaginosis and genital ulcer disease in their female partners," write the authors of the study."Thus, male circumcision reduces the risk of several sexually transmitted infections in both sexes, and these benefits should guide public health policies for neonatal, adolescent, and adult male circumcision programs." "We believe the cumulative scientific evidence supporting circumcision is now overwhelming." adds co-author Dr. Aaron Tobian.

Circumcision rates in the US have seen a dramatic drop in the last ten years. However, new research published in the past ten years has shown very significant inhibition by circumcision of the transmission of various STDs. Neither the Center for Disease Control (CDC) nor the American Association of Pediatrics (AAP) recommend or discourage the practice at this time. WebMD reports, however, that "both the CDC and the AAP are reportedly considering revisions to their infant circumcision policies in light of the new research."

Should this new study impact your attitude towards circumcision? We believe that published outcomes of randomized clinical trials in the past ten years have brought a high level of scientific proof to the advantages of circumcision in the prevention of STDs, and warrant reviewing the pros and cons of the practice. Endorsement of circumcision by the CDC and/or the AAP would make, our opinion, a decision in favor of circumcision based on medical evidence clear cut. The debate on circumcision, however, includes cultural issues which cannot always be brought down to scientific evidence.

Want to read more about it? Try Reuters, Doctors Lounge, TIME Magazine, Medscape, US News and World Report, ABC News, CBS News, WebMD, BusinessWeek/ HealthDay, Culture Clash Daily, eMaxHealth, UPI, or MedPage Today.

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