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Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya.

Publication ,  Journal Article
Smith, JS; Backes, DM; Hudgens, MG; Mei, W; Chakraborty, H; Rohner, E; Moses, S; Agot, K; Meijer, CJLM; Bailey, RC
Published in: Cancer Epidemiol Biomarkers Prev
June 2021

BACKGROUND: Male circumcision reduces the risk of human immunodeficiency virus infection in men. We assessed the effect of male circumcision on the incidence and natural history of human papillomavirus (HPV) in a randomized clinical trial in Kisumu, Kenya. METHODS: Sexually active, 18- to 24-year-old men provided penile exfoliated cells for HPV DNA testing every 6 months for 2 years. HPV DNA was detected via GP5+/6+ PCR in glans/coronal sulcus and in shaft samples. HPV incidence and persistence were assessed by intent-to-treat analyses. RESULTS: A total of 2,193 men participated (1,096 randomized to circumcision; 1,097 controls). HPV prevalence was 50% at baseline for both groups and dropped to 23.7% at 24 months in the circumcision group, and 41.0% in control group. Incident infection of any HPV type over 24 months was lower among men in the circumcision group than in the control group [HR = 0.61; 95% confidence interval (CI), 0.52-0.72]. Clearance rate of any HPV infection over 24 months was higher in the circumcision group than in the control group (HR = 1.87; 95% CI, 1.49-2.34). Lower HPV point-prevalence, lower HPV incidence, and higher HPV clearance in the circumcision group were observed in glans but not in shaft samples. CONCLUSION: Male circumcision reduced the risk of HPV acquisition and reinfection, and increased HPV clearance in the glans. IMPACT: Providing voluntary, safe, and affordable male circumcision should help reduce HPV infections in men, and consequently, HPV-associated disease in their partners.

Duke Scholars

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Published In

Cancer Epidemiol Biomarkers Prev

DOI

EISSN

1538-7755

Publication Date

June 2021

Volume

30

Issue

6

Start / End Page

1139 / 1148

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Persistent Infection
  • Penis
  • Penile Diseases
  • Papillomavirus Infections
  • Male
  • Kenya
  • Intention to Treat Analysis
  • Incidence
 

Citation

APA
Chicago
ICMJE
MLA
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Smith, J. S., Backes, D. M., Hudgens, M. G., Mei, W., Chakraborty, H., Rohner, E., … Bailey, R. C. (2021). Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya. Cancer Epidemiol Biomarkers Prev, 30(6), 1139–1148. https://doi.org/10.1158/1055-9965.EPI-20-1272
Smith, Jennifer S., Danielle M. Backes, Michael G. Hudgens, Wenwen Mei, Hrishikesh Chakraborty, Eliane Rohner, Stephen Moses, Kawango Agot, Chris J. L. M. Meijer, and Robert C. Bailey. “Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya.Cancer Epidemiol Biomarkers Prev 30, no. 6 (June 2021): 1139–48. https://doi.org/10.1158/1055-9965.EPI-20-1272.
Smith JS, Backes DM, Hudgens MG, Mei W, Chakraborty H, Rohner E, et al. Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya. Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1139–48.
Smith, Jennifer S., et al. “Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya.Cancer Epidemiol Biomarkers Prev, vol. 30, no. 6, June 2021, pp. 1139–48. Pubmed, doi:10.1158/1055-9965.EPI-20-1272.
Smith JS, Backes DM, Hudgens MG, Mei W, Chakraborty H, Rohner E, Moses S, Agot K, Meijer CJLM, Bailey RC. Male Circumcision Reduces Penile HPV Incidence and Persistence: A Randomized Controlled Trial in Kenya. Cancer Epidemiol Biomarkers Prev. 2021 Jun;30(6):1139–1148.

Published In

Cancer Epidemiol Biomarkers Prev

DOI

EISSN

1538-7755

Publication Date

June 2021

Volume

30

Issue

6

Start / End Page

1139 / 1148

Location

United States

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Persistent Infection
  • Penis
  • Penile Diseases
  • Papillomavirus Infections
  • Male
  • Kenya
  • Intention to Treat Analysis
  • Incidence