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Male Circumcision May Decrease Risk of HPV Infection and Cervical Cancer
December 18, 2008Two new studies suggest that male circumcision may assist in the prevention of human papillomavirus (HPV) infection, particularly infection with the high-risk subtypes associated with cervical, penile, and other cancers. Both studies are published in the January 1 issue of The Journal of Infectious Diseases, now available online.
High-risk subtypes of HPV have been estimated to be present in 99.7 percent of cervical cancers worldwide. Evidence has shown that women with circumcised partners have a reduced risk for genital cancer. Two new studies sought to discover if HPV infection is more likely to occur in uncircumcised compared with circumcised men.
Bertran Auvert MD, PhD, and his team of researchers in France and colleagues from South Africa studied data from a trial conducted in Orange Farm, South Africa. Uncircumcised men aged 18-24 years were randomized into either an intervention group, to be circumcised, or a control group, to remain uncircumcised. During this study, urethral swab samples were collected and analyzed for presence of HPV among men followed up for 21 months. Information about sexual behavior was also collected.
Dr. Auvert and colleagues found that the percentage of high-risk HPV genotypes was lower in the circumcised group than in the control group. The most important implication, according to researchers, was that "reducing the frequency of HPV infection among men will reduce the risk of exposure in their female sexual partners."
A second study by Carrie Nielson PhD, at the Oregon Health & Science University and colleagues at the University of Arizona, H. Lee Moffitt Cancer Center and Research Institute, and the Centers for Disease Control and Prevention tested more than four hundred men aged 18-40 years in two U.S. cities during 2002-2005. Sixteen percent of participants were uncircumcised. Researchers tested for HPV in skin swabs of the anogenital area and semen samples in participants with no HPV symptoms (such as warts or lesions).
Investigators found that circumcised men were about half as likely to have HPV as uncircumcised men, after adjustment for other differences in the two groups. These results demonstrated that lack of circumcision is associated with cervical cancer because of the increased risk of HPV infection. Nielson suggested that it may be useful to consider circumcising newborn boys in order to decrease the risk of HPV infection for them and their future partners. "Parents are not currently advised of this risk," she said. "These studies contribute to the evidence that might help to inform that decision."
In an accompanying editorial, Ronald H. Gray, MD, of Johns Hopkins University, said that the evidence was persuasive but not entirely consistent and that it may be premature to promote circumcision as a way to prevent HPV infection in men and to protect female sex partners from infection. He advised that policy decisions should await results from two ongoing trials of male circumcision. Alternatively, Gray noted that consistent evidence has suggested that male circumcision reduces the frequency of HIV infection in men. He also pointed out that because of the lack of conclusive data relating circumcision and prevention of HPV, Medicaid does not cover circumcision costs, which may account for a decline in neonatal circumcisions in the United States.
According to Dr. Nielson, the findings they reported present compelling arguments to promote male circumcision in developing countries where circumcision is not widely used and the HIV epidemic is severe. Additionally, she said, it is "the first clear demonstration of the indirect but substantial beneficial effect of male circumcision for women." The authors of both studies and the editorialist agreed that more studies will be needed to confirm the efficacy of male circumcision in HPV prevention.
Fast Facts:
1) The high-risk subtypes of HPV have been estimated to be present in 99.7 percent of cervical cancers worldwide.
2) One of the current studies showed that circumcised participants were half as likely to be infected with HPV as those who were uncircumcised.
3) Reducing the incidence of HPV infection among men will reduce the risk of HPV exposure in their female sexual partners.
Infectious Diseases Society of America
Dr. Auvert and colleagues found that the percentage of high-risk HPV genotypes was lower in the circumcised group than in the control group. The most important implication, according to researchers, was that "reducing the frequency of HPV infection among men will reduce the risk of exposure in their female sexual partners."
A second study by Carrie Nielson PhD, at the Oregon Health & Science University and colleagues at the University of Arizona, H. Lee Moffitt Cancer Center and Research Institute, and the Centers for Disease Control and Prevention tested more than four hundred men aged 18-40 years in two U.S. cities during 2002-2005. Sixteen percent of participants were uncircumcised. Researchers tested for HPV in skin swabs of the anogenital area and semen samples in participants with no HPV symptoms (such as warts or lesions).
Investigators found that circumcised men were about half as likely to have HPV as uncircumcised men, after adjustment for other differences in the two groups. These results demonstrated that lack of circumcision is associated with cervical cancer because of the increased risk of HPV infection. Nielson suggested that it may be useful to consider circumcising newborn boys in order to decrease the risk of HPV infection for them and their future partners. "Parents are not currently advised of this risk," she said. "These studies contribute to the evidence that might help to inform that decision."
In an accompanying editorial, Ronald H. Gray, MD, of Johns Hopkins University, said that the evidence was persuasive but not entirely consistent and that it may be premature to promote circumcision as a way to prevent HPV infection in men and to protect female sex partners from infection. He advised that policy decisions should await results from two ongoing trials of male circumcision. Alternatively, Gray noted that consistent evidence has suggested that male circumcision reduces the frequency of HIV infection in men. He also pointed out that because of the lack of conclusive data relating circumcision and prevention of HPV, Medicaid does not cover circumcision costs, which may account for a decline in neonatal circumcisions in the United States.
According to Dr. Nielson, the findings they reported present compelling arguments to promote male circumcision in developing countries where circumcision is not widely used and the HIV epidemic is severe. Additionally, she said, it is "the first clear demonstration of the indirect but substantial beneficial effect of male circumcision for women." The authors of both studies and the editorialist agreed that more studies will be needed to confirm the efficacy of male circumcision in HPV prevention.
Fast Facts:
1) The high-risk subtypes of HPV have been estimated to be present in 99.7 percent of cervical cancers worldwide.
2) One of the current studies showed that circumcised participants were half as likely to be infected with HPV as those who were uncircumcised.
3) Reducing the incidence of HPV infection among men will reduce the risk of HPV exposure in their female sexual partners.
Infectious Diseases Society of America
Male Circumcision Current Events and Male Circumcision News RSSCircumcision rates lower in states where Medicaid does not cover procedure
Hospitals in states where Medicaid does not pay for routine male circumcision are only about half as likely to perform the procedure, and this disparity could lead to an increased risk of HIV infection among lower-income children later in life, according to a UCLA AIDS Institute study.
Circumcision Reduces the Risk of HIV Infection in Heterosexual U.S. Men
A new U.S. study has found that being circumcised significantly reduced the risk of HIV infection in heterosexual African American men known to have been exposed to the virus.
Male circumcision efforts lag in Africa despite evidence of dramatic impact in preventing HIV
With millions of lives at stake over the next two decades, researchers and advocates at the AIDS 2008 Conference today called on the global health community to ramp up male circumcision to significantly reduce risk of HIV infection in Africa, and to move quickly to integrate the life-saving procedure into other comprehensive efforts to prevent transmission of the disease in the vulnerable nations of eastern and southern Africa.
New Male Circumcision Device for HIV Prevention Studied by NewYork-Presbyterian/Weill Cornell
With the recent endorsement by the World Health Organization (WHO) and scientists worldwide of adult male circumcision as an important strategy for HIV prevention, there is increased urgency to develop safe and cost-effective circumcision services. This is especially the case in Africa where HIV/AIDS continues to spread at an epidemic rate.
Is infant male circumcision an abuse of the rights of the child?
Circumcision is one of the commonest surgical procedures performed on males. Opponents argue that infant circumcision can cause both physical and psychological harm, while recent evidence shows that circumcision is medically beneficial.
The release of new data from the HVTN 502 HIV vaccine study
The new analyses revealed today from the STEP HIV vaccine clinical trial are both disappointing and puzzling. At this time, the data offer no clear explanations as to why the vaccine showed no measurable efficacy or why among individuals with background immunity to the adenovirus vector, there were more HIV infections in the vaccinees as compared to those in the placebo group.
Male circumcision for HIV prevention and more
Three clinical trials in Africa found that adult male circumcision reduced the risk of men acquiring HIV infection from heterosexual sex by 51-60%.
Male circumcision overstated as prevention tool against AIDS
In new academic research published today in the online, open-access, peer-reviewed scientific journal PLoS ONE, male circumcision is found to be much less important as a deterrent to the global AIDS pandemic than previously thought.
Scientists, public health leaders call for coordination in HIV prevention research
HIV prevention research was responsible for the recent revelation that male circumcision can play an important role in protecting men from infection with the deadly virus.
Circumcision: A proven strategy to prevent HIV
Male circumcision significantly reduces the risk of acquiring HIV in young African men, according to a study led by University of Illinois at Chicago professor of epidemiology Robert Bailey.
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Safe, Voluntary, Informed Male Circumcision and Comprehensive HIV Prevention Programming: Guidance for Decision-makers on Human Rights, Ethical and Legal Considerations (Unaids Publication) by World Health Organization (Publisher) Throughout the world HIV prevalence is generally lower in populations that practise male circumcision than in populations where most men are uncircumcised. This has been observed over the years of the epidemic and has been confirmed by three randomized controlled trials concluded in 2005-2006. The results have led to the conclusion that male circumcisionis and effective risk-reduction measure for men and should be used in addition to other known strategies for the prevention of heterosexually acquired infection. This book provides guidance to decision makers on human rights, ethical and legal considerations that need to be addressed before planning to provide male circumcision services within the response to HIV. |
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Whose Body, Whose Rights? - Examining the Ethics and the Human Rights Issue of Infant Male Circumcision (Censored Version) In a new era of children's rights, this independently produced two-part social issue documentary compassionately explores genital mutilation of unconsenting children, euphemistically termed "circumcision." It boldly and responsibly addresses these vital issues long overdue for inner reflection and cultural self-examination: history and medical ethics, consequences of circumcision, evolving religious attitudes, legal and constitutional issues, foreskin functions, men's awareness and uncircumcision, medical conscientious objection, children's rights. Recipient of the Creative Excellence award at the 1996 U.S. International Film and Video Festival, Honorable Mention at the 1996 Philadelphia Film Festival, and Best of Festival at the First Annual Stark Video & Film Festival (1997)." (Viewer... |
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Cut: Slicing Through the Myths of Circumcision (Home Use) Directed By: Eliyahu Ungar-Sargon Also With: Eliyahu Ungar-Sargon (Producer), Eliyahu Ungar-Sargon (Writer), Pennie Ungar-Sargon (Producer) Cut is a film that traces the intellectual journey of a man struggling to come to terms with his Jewish identity in the 21st century. Through the lens of circumcision, a central and ancient Jewish ritual, Cut asks the viewer to contemplate what happens when the Jewish tradition collides with the modern values of autonomy and individuality. Using the latest in scientific research, as well as conversations with rabbis, historians, and activists, Cut asks difficult questions about male circumcision and provides a rare emotional and intellectual experience. The filmmaker offered the following statement about Cut: "My intention with this film was to educate, enlighten, entertain, and ultimately raise the level of discourse on an important, but rarely discussed topic. A large part of Cut... |
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Circumcision Song Libinza Male Singers At Bobaka (Primary Contributor) |
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Cut: Slicing Through the Myths of Circumcision (Home Use) Directed By: Eliyahu Ungar-Sargon Also With: Eliyahu Ungar-Sargon (Producer), Eliyahu Ungar-Sargon (Writer), Pennie Ungar-Sargon (Producer) |
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Male and Female Circumcision: Medical, Legal, and Ethical Considerations in Pediatric Practice by Frederick Mansfield Hodges (Author), Marilyn Fayre Milos (Author), George C. Denniston (Author) Every year around the world 13.3 million boys and 2 million girls have part or all of their external sex organs cut off. Doctors, parents, and politicians have been misled into thinking that these mutilations are beneficial, necessary and harmless. International respected experts in the fields of medicine, science, politics, law, ethics, sociology, anthropology, history and religion present the latest research, documentation and analysis of this world-wide problem, focusing on the ethical, political and legal aspects of sexual mutilation; the cost and burden to healthcare systems; the latest medical research; anatomical and function consequences; religious and cultural aspects; psychological aspects; and the world-wide campaign to end sexual mutilation. |
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Cut: Slicing Through the Myths of Circumcision (Institutional Use: University/College) Directed By: Eliyahu Ungar-Sargon Also With: Eliyahu Ungar-Sargon (Producer), Eliyahu Ungar-Sargon (Writer), Pennie Ungar-Sargon (Producer) Cut is a film that traces the intellectual journey of a man struggling to come to terms with his Jewish identity in the 21st century. Through the lens of circumcision, a central and ancient Jewish ritual, Cut asks the viewer to contemplate what happens when the Jewish tradition collides with the modern values of autonomy and individuality. Using the latest in scientific research, as well as conversations with rabbis, historians, and activists, Cut asks difficult questions about male circumcision and provides a rare emotional and intellectual experience. The filmmaker offered the following statement about Cut: "My intention with this film was to educate, enlighten, entertain, and ultimately raise the level of discourse on an important, but rarely discussed topic. A large part of Cut... |
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Male Circumcision and Initiation in Rural Africa: Autobiography, Culture and Traditions by Amadou Nouhou Diallo (Author) This book not only gives you an idea about male circumcision in rural Africa, but it also gives you a sense of the importance of oral tradition in African societies. From the tale, to the myth while passing by the proverbs and riddles and until the epic narrations, there is always a teaching to pull, a value to instill. The purpose of this book is not to represent oral tradition as the only support of African societies, but to examine the technical innovations adapted to the land and the needs of the humans through discussion and transposition. The modern pedagogue must fear the oral tradition and try to recapture strength and the wealth that it once held, to associate them to his own methods. This Book will also show you that Africa is home to innumerable tribes and ethnic and social... |
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Circumcision Song Libinza Male Singers At Bobaka (Primary Contributor) |
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Cut: Slicing Through the Myths of Circumcision (Institutional Use: Library/Non-Profits) Directed By: Eliyahu Ungar-Sargon Also With: Eliyahu Ungar-Sargon (Producer), Eliyahu Ungar-Sargon (Writer), Pennie Ungar-Sargon (Producer) |
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