BRAZIL, MEXICO, USA: Circumcision does not protect against HPV

They tortured the data, but it wouldn't confess.


February 12, 2014

Circumcision does not protect against HPV

But it may slow the clearance of a cancer-causing HPV strain
by Morten Frisch
[A] New well-designed cohort study from Brazil, Mexico and the United States with more than 4000 participants pulls one of the American Academy of Pediatrics' (AAP) most promoted health claims apart. Overall, during follow-up there was no difference in rates of new HPV infections between circumcised and intact men in the study.

HPV is the group of sexually transmitted agents (human papillomaviruses) that cause both anogenital warts (aka condyloma) and neoplastic lesions and cancers of both male and female genitalia, the anus and the tonsils.

Two types of HPV, known as HPV6 and HPV16, are responsible for the majority of all HPV-associated lesions, including genital warts (HPV6) and cancers (HPV16). While the overall findings of this study were negative, meaning that it found no overall differences between circumcised and intact men, among the few type-specific differences that were actually found, was a significantly reduced ability among circumcised men to clear their newly acquired HPV6 and HPV16 infections. This is particularly worrisome, because it is well-established that persistent HPV16 infection is the initial step on the path from HPV acquisition to cancer.

With this study, one of Brian J. Morris' and the AAP's most cherished arguments in favor of circumcision falls apart. Notably in industrialized parts of the world where the burden of heterosexually acquired HIV/AIDS - the main health problem circumcision is postulated to reduce - is low.

The paper must be even more disturbing to the pro-circumcision lobby, because two of its authors, Xavier Castellsague and Francois Xavier Bosch, are prominent co-authors of several prior papers suggesting a protective effect of circumcision against HPV infection, including the 2002 landmark study in the acclaimed New England Journal of Medicine [Rebutted on this site.], whose findings are now seriously undermined by their new and methodologically stronger study.
It seems there may soon be one pro-circumcision myth less to fight.

BRAZIL: Circumcision kills one in 7700 (=156 deaths/p.a. in the USA)

Einstein (Sao Paulo) 2012 Sep;10(3):342-346.

Circumcisions for medical reasons in the Brazilian public health system: epidemiology and trends.

Korkes F, Silva Ii JL Pompeo AC

Abstract
OBJECTIVE:
To evaluate the epidemiological factors associated to medical circumcision, based on data from the Brazilian public health system.

METHODS: Using the Unified Health System public database between 1984 and 2010, hospital admissions associated with surgical treatment of phimosis were searched. A total of 668,818 men admitted to public hospitals who underwent circumcision were identified and included in the present study.

RESULTS:
A mean±standard deviation of 47.8±13.4 circumcisions/100,000 men/year was performed through the Unified Health System for medical reasons. During the 27-year period evaluated, 1.3% of the male population required circumcision for medical reasons. [So 98.7% of routine circumcisions are wasted on boys and men who will never need it.] Total number of circumcisions and circumcision rate increased in childhood, declined progressively after 5 years of age and rose again progressively after the sixth decade of life. In the regions of the country with better access to healthcare, 5.8% of boys aged 1 to 9 years old required circumcisions. [Or were circumcised whether they needed it or not.] From 1992 to 2010 there were 63 deaths associated with circumcisions (mortality rate of 0.013%).

[That's one death in 7692 circumcisions. In this USA, that would amount to 156 circumcision deaths per year.]

CONCLUSION:
In conclusion, yearly circumcision rates could be estimated in Brazil, and a very low mortality rate was associated with this procedures. Circumcision is mostly performed in children in the first decade of life and a second peak of incidence of penile foreskin diseases occurs after the sixth decade of life, when circumcision is progressively performed again.

[This study was circulated by Prof. Brian Morris, who presumably thinks this is an "acceptable" death rate.]