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MALE CIRCUMCISION AND LOWER PREVALENCE OF HPV LESIONS IN KENYAN MEN

Sunday, 12th of June 2011

‘This study suggests that circumcision reduces the prevalence of HPV-associated flat lesions and may ultimately reduce male to female HPV transmission.’

Male circumcision is associated with a lower prevalence of human papillomavirus-associated penile lesions among Kenyan men

1. Danielle M. Backes^1,*,†,
2. Maaike C.G. Bleeker²,
3. Chris J.L.M. Meijer²,
4. Michael G. Hudgens³,
5. Kawango Agot⁴,
6. Robert C. Bailey⁵,
7. J.O. Ndinya-Achola⁶,
8. Juma Hayombe⁷,
9. Cornelis J.A. Hogewoning⁸,
10. Stephen Moses⁹,
11. Peter J.F. Snijders²,
12. Jennifer S. Smith^1,*,‡

Abstract below; full text, to subscribers, at http://onlinelibrary.wiley.com/doi/10.1002/ijc.26196/pdf

 

International Journal of Cancer

Author Information

1.  

Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

1. ²

Department of Pathology, VU University Medical Center, Amsterdam, the Netherlands

1. ³

Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA

1. ⁴

Impact Research and Development Organization, Kisumu, Kenya

1. ⁵

Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Illinois, USA

1. ⁶

University of Nairobi, Nairobi, Kenya

1. ⁷

Nyanza Reproductive Health Society, Kisumu, Kenya

1. ⁸

Albert Schweitzer Hospital, Dordrecht, the Netherlands

1. ⁹

Centre for Global Public Health, University of Manitoba, Winnipeg, Canada

Email: Danielle M. Backes (backes@email.unc.edu) Jennifer S. Smith (jennifers@unc.edu)

*Correspondence: Danielle M. Backes, Jennifer S. Smith, Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599

Publication History

1. Accepted manuscript online: 26 MAY 2011 09:19AM EST
2. Manuscript Accepted: 8 APR 2011
3. Manuscript Revised: 3 MAR 2011
4. Manuscript Received: 9 DEC 2010

Funded by

• National Cancer Institute, National Institutes of Health (NIH). Grant Number: R01 CA114773-04
• Division of AIDS, NIAID, NIH. Grant Number: AI50440
• Canadian Institutes of Health Research (CIHR). Grant Number: HCT 44180
• NIH. Grant Number: 2-T32-CA009330
• CIHR Investigator Award

• Abstract
• Cited By

Abstract

Human papillomavirus (HPV)-associated penile lesions in men may increase the risk of HPV transmission to their female partners. Risk factor data on HPV-associated penile lesions are needed from regions with a high burden of cervical cancer. Visual inspection of the penis was conducted using a colposcope at the 24-month visit among participants in a randomized controlled trial of male circumcision in Kenya, from May 2006 to October 2007. All photos were read independently by two observers for quality control. Penile exfoliated cells sampled from the glans/coronal sulcus and the shaft were tested for HPV DNA using GP5+/6+ PCR and for HPV16, 18 and 31 viral loads using a real time PCR assay. Of 275 men, 151 were circumcised and 124 uncircumcised. The median age was 22 years. Circumcised men had a lower prevalence of flat penile lesions (0.7%) versus uncircumcised (26.0%); adjusted odds ratio [OR]=0.02; 95% confidence interval [CI]: 0.003-0.1). Compared to men who were HPV-negative, men who were HPV DNA positive (OR=6.5; 95%CI: 2.4-17.5) or who had high HPV16/18/31 viral load (OR=5.2; 95%CI: 1.1-24.4) had higher odds of flat penile lesions. Among men with flat penile lesions, HPV56 (29.0%) and 16 (25.8%) were the most common types. Flat penile lesions are much more frequent in uncircumcised men, and associated with higher prevalence of HPV and higher viral loads. This study suggests that circumcision reduces the prevalence of HPV-associated flat lesions and may ultimately reduce male to female HPV transmission. © 2011 Wiley-Liss, Inc.