Circumcised Men Less Likely to Get Virus That Causes Cervical Cancer

According to a study in this week's New England Journal of Medicine (No. 346; Vol. 15), women whose sex partners are circumcised may be less likely to get cervical cancer. The study found that men with intact foreskins were three times more likely than circumcised men to be infected with human papillomavirus. That, in turn, may increase the risk of passing the virus on to their sex partners. The theory is that the foreskin's inner lining is especially vulnerable to the virus. This also raises questions about whether circumcision can reduce the spread of HIV. Studies dating back to at least 1988 have suggested that circumcision offers some protection against AIDS, but the research does not prove it, and more definitive studies are underway.

Conducted by researchers in Spain and four other countries and supported by the International Agency for Research on Cancer in France, the cervical cancer study looked at nearly 3,800 women, half of whom had cervical cancer and half of whom were cancer-free. There was only a slight overall difference between the two groups in how many had circumcised partners and how many had uncircumcised ones. But the researchers found a strong difference in the risk of cervical cancer when it came to women whose partners were especially sexually active. Women whose high- risk partners were not circumcised were five times more likely to get cancer than those whose partners were circumcised. High-risk men were defined as those who had at least six sex partners and started having sex before age 17.

Researcher Dr. Xavier Castellsague of the Catalan Institute for Oncology in Barcelona said it would not make sense to promote circumcision as a way to control cervical cancer in the United States, where Pap smears usually detect it at a treatable stage. However, he said circumcision could make a big difference in developing countries where there is no regular screening for cervical cancer.

But Ronald Goldman, executive director of the Circumcision Resource Center, which opposes the procedure, said the study is unreliable because it pools data from seven studies in five countries. "Cutting off a normal healthy functioning body part to prevent an unlikely disease or infection would be like pulling healthy teeth to prevent tooth decay," he said.

Dr. Stephen Moses of the microbiology department at the University of Manitoba said he and other researchers have begun recruiting patients in Kenya, which is hard-hit by AIDS, for a two-year study of whether circumcision can reduce the spread of HIV.

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