Nature Medicine | Spoonful of Medicine

Circumcision cuts prostate cancer risk—but only a bit

Scientists have found more evidence for yet another health benefit of circumcision for young males. In addition to reducing the risk of urinary tract problems, penile cancer and sexually transmitted infections, doctors might now add lower rates of prostate cancer to the mix. In a study of nearly 3,400 men, researchers at the Fred Hutchinson Cancer Research Center (FHCRC) in Seattle found that males who were circumcised before their first sexual encounter were somewhat less likely to develop prostate cancer in later life compared to uncircumcised men.

“The study provides even more reason for parents to opt for this ‘surgical vaccine’ to protect their baby boy from infections,” Brian Morris, a molecular biologist at the University of Sydney Medical School in Australia, who was not involved in the research, wrote in an email.

Over the past 60 years, a smattering of reports has appeared in the literature suggesting that male circumcision might protect against prostate cancer. But the largest of these papers, a study conducted more than 20 years ago in Southwest England, included only 161 men with prostate cancer and a comparable number of healthy controls. In contrast, in the latest report the authors compared 1,754 cases of prostate cancer in men aged 35 to 74 and 1,645 age-matched controls. Using this much larger cohort, the researchers showed that men circumcised before they first had sexual intercourse had a 18% reduced risk of developing aggressive prostate cancer and a 12% lower risk for less aggressive forms of the disease. The benefit of circumcision was found in both African Americans and Caucasians, although the effect was greater in the former group.

Because circumcision is thought to reduce transmission rates of viruses such as HIV, “we see this as another piece of the puzzle that infection and inflammation may play a role in prostate cancer development,” FHCRC epidemiologist Janet Stanford, who led the work reported online today, told Nature Medicine.

According to Morris, the finding that infant circumcision conferred protection against cancer—but circumcision after sexual debut did not—also adds support to an opinion article he published last month in BMJ Pediatrics in which he argued that infancy is the best time to circumcise males since it provides the greatest lifelong protection from disease. A strategy that involves circumcising all young boys, Morris notes, could prevent around 50,000 cases of prostate cancer each year in the US alone, which would translate into an annual savings of around $1 billion for the country’s healthcare system.

“Governments need to act to encourage infant circumcision,” says Morris, the author of the 1999 book In Favour of Circumcision. At present, Medicaid, the US health program for low-income Americans, only covers circumcision in two-thirds of all states.

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