Findings from Kenya: Male circumcision reduces HPV infections
May 10, 2021
It’s well-established that male circumcision reduces the risk of human immunodeficiency virus (HIV) infection in men. A recent study from Kenya, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, finds that male circumcision also reduces men’s risk of infection with human papillomavirus (HPV).
HPV infection is the major cause of invasive cervical cancer and an important cause of oral, penile and anal cancers. These results are doubly important because men play a crucial role in the development of cervical, vaginal and vulvar cancers, as they can transmit penile HPV infection to female sexual partners. While HPV vaccines exist, they are not widely available in many geographical regions and are targeted to young adolescents.
Professor Jennifer S. Smith, PhD, from the UNC Gillings School of Global Public Health’s Department of Epidemiology, was the lead author. Co-authors from the Gillings School include alumna Danielle Backes, PhD, and research collaborator Eliane Rohner, PhD, both affiliated with the epidemiology department; and Michael Hudgens, PhD, professor and associate chair, and Wenwen Mei, doctoral student, both with the Department of Biostatistics.
Their findings come from a randomized clinical trial of 2,193 uncircumcised, HIV negative, sexually active men ages 18-24 years old that took place in Kisumu, Kenya. 1,096 participants underwent male circumcision while 1,097 remained uncircumcised as part of the control group, and they all provided cell samples for HPV DNA testing every six months for two years.
HPV prevalence was 50% at baseline for both groups and dropped to 23.7% at 24 months in the circumcision group and 41% in the control group. Incident infection of any HPV type over 24 months was lower among men in the circumcision group, and circumcision also improved HPV clearance in the glans, meaning the virus was more likely to go away and not return.
“Male circumcision is a valuable tool for HIV prevention,” says Smith. “Given our results, male circumcision should be considered effective for preventing the risk of HPV incidence, re-infection, and increase HPV clearance. Thus, male circumcision can contribute to the primary prevention of penile, anal, cervical and other HPV-associated cancers, synergistically with HPV vaccination programs.”
Based on these findings, the authors suggest that providing voluntary, safe and affordable male circumcision will help reduce HPV infections in men, and consequently, lower the rate of HPV-associated disease in their partners.
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