Relationship between circumcision and human papillomavirus infection: a systematic review and meta-analysis. 2017

Yi-Ping Zhu, and Zhong-Wei Jia, and Bo Dai, and Ding-Wei Ye, and Yun-Yi Kong, and Kun Chang, and Yue Wang
Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, China.

Male circumcision (MC) is reported to reduce human papillomavirus (HPV) prevalence in men. However, the efficacy remains imprecise. The aim of this study was to conduct a systematic review and meta-analysis to assess the relationship between MC and genital HPV infection and genital warts. PUBMED, EMBASE, and Web of Science were searched from inception to March 22, 2015. We identified 30 papers, including a total of 12149 circumcised and 12252 uncircumcised men who were evaluated for the association of circumcision with genital HPV or genital warts. Compared with men who were not circumcised, circumcised men may have had significantly reduced odds of genital HPV prevalence (odds ratio [OR]: 0.68; 95% confidence interval [95% CI]: 0.56-0.82). There was no significant association between MC and genital HPV acquisition of new infections (OR: 0.99; 95% CI: 0.62-1.60), genital HPV clearance (OR: 1.38; 95% CI: 0.96-1.97), and prevalence of genital warts (OR: 1.17; 95% CI: 0.63-2.17). This meta-analysis suggests that circumcision reduces the prevalence of genital HPV infections. However, no clear evidence was found that circumcision was associated with decreased HPV acquisition, increased HPV clearance, or decreased the prevalence of genital warts. More studies are required to evaluate adequately the effect of MC on the acquisition and clearance of HPV infections and prevalence of genital warts.

UI MeSH Term Description Entries
D008297 Male Males
D002944 Circumcision, Male Excision of the prepuce of the penis (FORESKIN) or part of it. Male Circumcision,Circumcisions, Male,Male Circumcisions
D003218 Condylomata Acuminata Sexually transmitted form of anogenital warty growth caused by the human papillomaviruses. Genital Warts,Venereal Warts,Warts, Genital,Warts, Venereal,Genital Wart,Venereal Wart,Wart, Genital,Wart, Venereal
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015995 Prevalence The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time. Period Prevalence,Point Prevalence,Period Prevalences,Point Prevalences,Prevalence, Period,Prevalence, Point,Prevalences
D016017 Odds Ratio The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases. Cross-Product Ratio,Risk Ratio,Relative Odds,Cross Product Ratio,Cross-Product Ratios,Odds Ratios,Odds, Relative,Ratio, Cross-Product,Ratio, Risk,Ratios, Cross-Product,Ratios, Risk,Risk Ratios
D060737 Reproductive Tract Infections Infections of the genital tract in females or males. They can be caused by endogenous, iatrogenic, or sexually transmitted organisms. Genital Tract Infections,Genital Tract Infection,Infection, Genital Tract,Infection, Reproductive Tract,Infections, Genital Tract,Infections, Reproductive Tract,Reproductive Tract Infection
D030361 Papillomavirus Infections Neoplasms of the skin and mucous membranes caused by papillomaviruses. They are usually benign but some have a high risk for malignant progression. HPV Infection,Human Papillomavirus Infection,HPV Infections,Human Papillomavirus Infections,Papillomavirus Infection,Papillomavirus Infection, Human,Papillomavirus Infections, Human
D065840 Protective Factors An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with prevention or mitigation of a health-related condition considered important to prevent. Factor, Protective,Factors, Protective,Protective Factor

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