Circumcision Linked to Lower Risk of Prostate Cancer

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A new study published in the journal Cancer found that circumcision may help protect against prostate cancer [1]. The research suggests that circumcision can hinder infection and inflammation that may lead to prostate carcinogenesis.

Circumcision is a relatively common procedure in which the foreskin of the penis is surgically removed. According to U.S. Centers for Disease Control and Prevention, around 55% of newborn boys are circumcised in hospital [2], while an additional (but unreported) percentage are circumcised in religious ceremonies shortly after birth.

The procedure is not without controversy; medical practitioners and organizations are split on whether circumcision should be routinely performed on newborns. The American Academy of Pediatrics does not currently make a recommendation regarding routine infant circumcision [3]. While there are some minor risks associated with the procedure (as with any minor surgery), there is currently no strong, well-conducted scientific research demonstrating physical or psychological harm, or loss of function associated with circumcision. Much of the concern regarding routine infant circumcision is of an ethical nature, as some physicians struggle to justify a surgical alteration that may not be medically necessary.

Mounting evidence, however, supports the health benefits of circumcision. In a commentary published in the journal Pediatrics, Dr. Edgar Schoen notes that studies show a significant reduction in the risk of HPV and HIV infection, urinary tract infection, penile cancer, and certain STDs in circumcised men. Female partners of circumcised men are less likely to contract STDs, and have lower rates of cervical cancer [4]. The lower rates of disease are due in part to the generally improved hygiene of a circumcised penis, and in part to the presence of receptors for certain viruses — including HIV — in the foreskin [5].

Researchers from the University of Washington School of Medicine and the Fred Hutchinson Cancer Research Center in Seattle, Washington, analyzed information from 3,399 men. They compared data from a group of 1,754 men circumcised before their first sexual intercourse with a control group of 1,645 men who were uncircumcised. The circumcised men had a 15% lower rate of prostate cancer. While this study was not randomized (and it’s therefore possible that the circumcised men shared other genetic traits or behavioral factors that reduced their risk of cancer), it’s nevertheless an interesting correlation. Further, given that many cancers are now linked to viral infection and given the reduced risk of several viral infections associated with circumcision, these findings fall well within the confines of the scientifically plausible.

According to Dr. Jonathan Wright, lead author on the study and an assistant professor of urology at the University of Washington School of Medicine [6]:

These data are in line with an infectious/inflammatory pathway which may be involved in the risk of prostate cancer in some men. Although observational only, these data suggest a biologically plausible mechanism through which circumcision may decrease the risk of prostate cancer. Future research of this relationship is warranted.

References

1. Wright et al. Circumcision and the risk of prostate cancer. Cancer. 2012 Mar 12. doi: 10.1002/cncr.26653. [Epub ahead of print]
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2. CDC. Trends in in-hospital newborn male circumcision–United States, 1999-2010. MMWR Morb Mortal Wkly Rep. 2011 Sep 2;60(34):1167-8.
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3. AAP. Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision. Pediatrics. 1999 Mar;103(3):686-93.
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4. Schoen, E. Ignoring evidence of circumcision benefits. Pediatrics. 2006 Jul;118(1):385-7.
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5. Szabo et al. How does male circumcision protect against HIV infection? BMJ. 2000 Jun 10;320(7249):1592-4.
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6. Circumcision may reduce prostate cancer risk. Fred Hutchinson Cancer Research Center. 2012 Mar 12.