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Meta-Analysis
. 2011 Aug;22(8):1097-110.
doi: 10.1007/s10552-011-9785-9. Epub 2011 Jun 22.

Male circumcision and penile cancer: a systematic review and meta-analysis

Natasha L Larke  1 , Sara L Thomas, Isabel dos Santos Silva, Helen A Weiss
Affiliations
Meta-Analysis

Male circumcision and penile cancer: a systematic review and meta-analysis

Natasha L Larke et al. Cancer Causes Control. 2011 Aug.

Abstract

Objective: We systematically reviewed the evidence of an association between male circumcision and penile cancer.

Methods: Databases were searched using keywords and text terms for the epidemiology of penile cancer. Random effects meta-analyses were used to calculate summary odds ratios (ORs) and 95% confidence intervals (CI).

Results: We identified eight papers which evaluated the association of circumcision with penile cancer, of which seven were case-control studies. There was a strong protective effect of childhood/adolescent circumcision on invasive penile cancer (OR = 0.33; 95% CI 0.13-0.83; 3 studies). In two studies, the protective effect of childhood/adolescent circumcision on invasive cancer no longer persisted when analyses were restricted to boys with no history of phimosis. In contrast, there was some evidence that circumcision in adulthood was associated with an increased risk of invasive penile cancer (summary OR = 2.71; 95% CI 0.93-7.94; 3 studies). There was little evidence for an association of penile intra-epithelial neoplasia and in situ penile cancer with circumcision performed at any age.

Conclusions: Men circumcised in childhood/adolescence are at substantially reduced risk of invasive penile cancer, and this effect could be mediated partly through an effect on phimosis. Expansion of circumcision services in sub-Saharan Africa as an HIV prevention strategy may additionally reduce penile cancer risk.

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Figures

Fig. 1
Fig. 1
Flow chart of study selection for inclusion in the systematic review. §3 papers evaluated the effect of circumcision on both in situ and invasive penile cancer. †The search was conducted as part of a wider search strategy to identify papers on the association of male circumcision with HPV, genital warts and penile cancer
Fig. 2
Fig. 2
Association of male circumcision and PIN (I–III) or in situ penile carcinoma: random effects meta-analysis
Fig. 3
Fig. 3
Association of male circumcision and invasive penile carcinoma: random effects meta-analysis
See this image and copyright information in PMC

References

    1. Parkin DM, Bray F (2006) Chapter 2: The burden of HPV-related cancers. Vaccine 24(Suppl 3):S3/11-25 - PubMed
    1. Parkin DM. Cancer incidence in five continents. Lyon: International Agency for Research on Cancer; 2002.
    1. Parkin DM, Ferlay J, Hamdi-Cherif M, Sitas F, Thomas JO, Wabinga H, et al. Cancer incidence in Africa. Lyon: International Agency for Research on Cancer; 2003.
    1. Wabinga HR, Parkin DM, Wabwire-Mangen F, Nambooze S. Trends in cancer incidence in Kyadondo County, Uganda, 1960–1997. Br J Cancer. 2000;82(9):1585–1592. doi: 10.1054/bjoc.1999.1071. - DOI - PMC - PubMed
    1. Parkin DM, Nambooze S, Wabwire-Mangen F, Wabinga HR. Changing cancer incidence in Kampala, Uganda, 1991–2006. Int J Cancer. 2010;126(5):1187–1195. - PubMed

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