Male circumcision lowers prevalence of penile precancerous lesions among African men, study finds

An international study led by researchers at the University of North Carolina at Chapel Hill shows that among Kenyan men, circumcision is associated with a lower prevalence of human papillomavirus-associated precancerous lesions of the penis. Human papillomavirus (HPV) is a sexually transmitted virus that plays an important role in genital cancers in men and women, including cancers of the penis and cervix.

“Our data are the first to show that male circumcision may reduce HPV-associated penile precancerous lesions,” said Jennifer Smith, PhD, senior author. “This represents an additional public health benefit of male circumcision.”

Smith is associate professor of epidemiology in the UNC Gillings School of Global Public Health and a member of UNC Lineberger Comprehensive Cancer Center. The study was published May 26 as an early-view, online manuscript in the International Journal of Cancer.

 

“The percentage of men with HPV-associated precancerous penile lesions was substantially higher among those who were not circumcised (26 percent) as compared to those who were circumcised (0.7 percent),” Smith said. “Interventions that reduce HPV-associated penile lesions could be important to both men and women, because such lesions may increase HPV transmission from men to their sexual partners.”Smith said that circumcision also may provide a useful intervention to prevent HPV-associated penile lesions – and ultimately, in less developed countries, invasive cervical cancers – since prophylactic HPV vaccines may not be readily available to men, and current HPV vaccines do not include protection against all high-risk HPV types.

The study was part of a larger trial, conducted by Robert Bailey, PhD, at the University of Illinois at Chicago, which was undertaken to determine the effectiveness of male circumcision in reducing HIV incidence. In the UNC-led study, 275 men participated, 151 of whom were circumcised and 124 of whom were not. The protocol included a visual inspection of the penis to identify lesions, photographs that were read independently by two observers and a sample of penile exfoliated cells that were tested for HPV infection.

In addition to Smith, UNC contributors are Danielle Backes, PhD, the report’s first author and postdoctoral fellow in epidemiology, and Michael Hudgens, PhD, research associate professor of biostatistics, both from the UNC public health school.

 

Other study researchers are from the Department of Pathology at Vrije Universiteit Medical Center in Amsterdam, and the Albert Schweitzer Hospital in Dordrecht, both in the Netherlands; the Nyzanza Reproductive Health Society in Kisumu, Kenya; the Division of Epidemiology and Biostatistics at the University of Illinois at Chicago’s School of Public Health; the University of Nairobi (Kenya); and the Centre for Global Public Health at the University of Manitoba in Winnipeg, Canada.Funding for the research was provided by grants from the National Cancer Institute and the Canadian Institute of Health Research.

 

UNC Gillings School of Global Public Health contact: Ramona DuBose, director of communications, (919) 966-7467 or ramona_dubose@unc.edu.