title: Male circumcision and prevalence of genital human papillomavirus infection in men: a multinational study.
abstract: BACKGROUND
  Accumulated evidence from epidemiological studies and more recently from randomized controlled trials suggests that male circumcision (MC) may substantially protect against genital HPV infection in men. The purpose of this study was to assess the association between MC and genital HPV infection in men in a large multinational study.
  
  
  METHODS
  A total of 4072 healthy men ages 18-70 years were enrolled in a study conducted in Brazil, Mexico, and the United States. Enrollment samples combining exfoliated cells from the coronal sulcus, glans penis, shaft, and scrotum were analyzed for the presence and genotyping of HPV DNA by PCR and linear array methods. Prevalence ratios (PR) were used to estimate associations between MC and HPV detection adjusting for potential confounders.
  
  
  RESULTS
  MC was not associated with overall prevalence of any HPV, oncogenic HPV types or unclassified HPV types. However, MC was negatively associated with non-oncogenic HPV infections (PR 0.85, 95% confident interval: 0.76-0.95), in particular for HPV types 11, 40, 61, 71, and 81. HPV 16, 51, 62, and 84 were the most frequently identified genotypes regardless of MC status.
  
  
  CONCLUSIONS
  This study shows no overall association between MC and genital HPV infections in men, except for certain non-oncogenic HPV types for which a weak association was found. However, the lack of association with MC might be due to the lack of anatomic site specific HPV data, for example the glans penis, the area expected to be most likely protected by MC.
authors: Unit of Infections and Cancer (UNIC), Cancer Epidemiology Research Program (CERP), Catalan Institute of Oncology (ICO), L'Hospitalet de Llobregat 08908, Barcelona, Spain.
authors: Ginesa
authors: G
authors: Albero
authors: Luisa L
authors: LL
authors: Villa
authors: Eduardo
authors: E
authors: Lazcano-Ponce
authors: William
authors: W
authors: Fulp
authors: Mary R
authors: MR
authors: Papenfuss
authors: Alan G
authors: AG
authors: Nyitray
authors: Beibei
authors: B
authors: Lu
authors: Xavier
authors: X
authors: Castellsagué
authors: Martha
authors: M
authors: Abrahamsen
authors: Danélle
authors: D
authors: Smith
authors: F Xavier
authors: FX
authors: Bosch
authors: Jorge
authors: J
authors: Salmerón
authors: Manuel
authors: M
authors: Quiterio
authors: Anna R
authors: AR
authors: Giuliano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D002944:Circumcision, Male; D005837:Genitalia, Male / Q000821:virology*; D005838:Genotype; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae / Q000145:classification / Q000235:genetics; D030361:Papillomavirus Infections / Q000453:epidemiology*; D015995:Prevalence; D012747:Sexual Partners; D012749:Sexually Transmitted Diseases / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult