There are few issues that bring up as much controversy and debate today as the issue of male circumcision. Regardless of where consumers stand on this issue, it is crucially important to take a unbiased look at all of the new research. Is it valid? Has the research been replicated? Should those findings change our understanding of male circumcision? Do the results change how or why we do things? To answer some of those questions, here is a review of the some of the most current research on male circumcision.
Study Shows HPV Risk May be Lower in Circumcised Men
A study published in the May 2011 issue of the International Journal of Cancer examined the relationship of circumcision to the human papillomavirus (HPV) and transmission to female partners. The 18-month randomized controlled trial (RCT) was conducted in Kenya and consisted of 275 men; 151 who were circumcised and 124 who were not. The median age of men participating in the study was 22.
This study found that the circumcised men had a lower incidence of flat penile lesions associated with HPV (.7%) versus the men who were uncircumcised (26%). Though the overall sample size in this study group was small, its results are valid given that it was a prospective RCT. Authors conclude that "this study suggests that circumcision reduces the prevalence of HPV-associated flat lesions and may ultimately reduce male to female HPV transmission."
Low-Risk HPV and HIV Infection Affected by Circumcision
A substantially larger study was recently published online in April 2011 and also in a recent issue of Infections Diseases in Obstetrics and Gynecology. A team of researchers from France and South Africa conducted a RCT for 2 1/2 years on over 1,700 young men ages 18-22 living in Orange Farm, South Africa. The men were tested and followed over a 21-month period of time.
The research team discovered the prevalence of both HIV and low-risk HPV was lower among the circumcised men (8.5%) versus the uncircumcised participants (15.8%) despite the fact that there were no significant differences in condom use, number of sexual partners and education levels between the groups.
"[Male circumcision] MC, an immediately available and cost-effective method, was proven to reduce HR-HPV infection," authors conclude. "Hence the protective effect of MC on LR-HPV, demonstrated in this study, provides new arguments endorsing the WHO-UNAIDS recommendation for the implementation of MC programs in targeted countries."
Deaths as a Result of Traditional Male Circumcision
A South African study from the October 2010 issue of Medicine, science and the law examines the number of deaths associated with traditional forms of male circumcision in the Xhosa population.
Medical records obtained from the Mthatha General Hospital from 2005-2006 indicated that there were 25 deaths as a result of traditional male circumcision. The most frequent causes of death were due to septicaemia and pneumonia. The youngest victim on record was 12 years old. Researchers conclude that "the mortality associated with traditional male circumcision in the Mthatha area of South Africa is alarming."
The Debate Over Male Circumcision
Even with a review of many of the valid studies, it is impossible to draw a conclusion that circumcision is the right, best or even healthiest decision for every male in every part of the world. When looking at the existing research, we can see obvious problems. Very little research is being done on populations outside of Africa, which makes it harder to draw any conclusions for other populations. More research on male circumcision is definitely needed in developed countries.
Another limitation that male circumcision, be it traditional or medical, carries with it a set of risks that may or may not outweigh the benefits. These risks of male circumcision (with the exception of the traditional circumcision death rate study) are not covered here but are readily found from recognized sources.
Perhaps the only conclusion consumers can make is to read every valid and current research study available and to make the best decision for themselves and their families based on that knowledge.
References:
- Backes, DM., et. al., "Male circumcision is associated with a lower prevalence of human papillomavirus-associated penile lesions among Kenyan men," International Cancer Journal, May 2011.
- Tarnaud, C. Et al., "Association of Low-Risk Human Papillomavirus Infection with Male Circumcision in Young Men: Results from a Longitudinal Study Conducted in Orange Farm, South Africa," Infections Diseases in Obstetrics and Gynecology, 2011.
- Meel, BL., "Traditional male circumcision-related fatalities in the Mthatha area of South African," Medicine, science and the law, October 2010.
- WebMD, Circumcision Basics
Brenda Lane - Brenda Lane is a published author, Lamaze certified childbirth educator, DONA certified birth doula and approved birth doula trainer.
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