Circumcision reduces prostate cancer risk

Circumcision before a male’s first sexual intercourse may help protect against prostate cancer, U.S. researchers suggested.

Lead author Dr. Jonathan L. Wright, an affiliate investigator in the Hutchinson Center’s Public Health Sciences Division, said circumcision could hinder infection and inflammation that may lead to this malignancy.

Wright and colleagues analyzed data from 3,399 men - 1,754 with prostate cancer and 1,645 without.

The study, published online ahead of the print edition of the journal Cancer, found men who had been circumcised before their first sexual intercourse were 15 percent less likely than uncircumcised men to develop prostate cancer.

Men circumcised before their first sexual intercourse had a 12 percent reduced risk for developing less aggressive prostate cancer and an 18 percent reduced risk for developing more aggressive prostate cancer, the study said.

Sexually transmitted infections may lead to prostate cancer by causing chronic inflammation that creates a hospitable environment for cancer cells, but other mechanisms may also be involved, Wright said.

How common is circumcision?
About one-fifth of men worldwide have been circumcised, mostly for religious and cultural reasons when the procedure is commonly performed shortly after birth or around puberty.
Although adults are occasionally circumcised as an act of religious dedication, adult circumcision is most commonly performed for medical reasons.

Circumcision may protect against sexually transmitted infections, and therefore prostate cancer, by toughening the inner foreskin and by getting rid of the moist space under the foreskin that may help pathogens survive, the study said.

Circumcision for a medical reason

Medical reasons for Circumcision include phimosis, acute balanoposthitis or paraphimosis.

In phimosis the opening of the foreskin is narrowed, preventing retraction. Occasionally, the edge of the foreskin has a white, scarred, inelastic appearance and will not pucker open as it is retracted.

Between 1 and 1.5 per cent of boys will develop this condition by the time they are 17 years old.
Symptoms can include:

irritation or bleeding from the edge of the foreskin, particularly during sexual intercourse or masturbation
stinging or pain on passing urine (dysuria)
inability to pass urine if the foreskin is very tight.

The changes in the prepuce are due to a condition known as balanitis xerotica obliterans. Circumcision is advisable in most cases.

Acute balanoposthitis
This condition involves redness and swelling of the foreskin, together with a discharge of pus from the space between the foreskin and the glans.

Sometimes the whole penis may be swollen and inflamed. Between 3 and 10 per cent of boys will develop this condition, depending on how the condition is defined.

Balanoposthitis is very occasionally the first sign of diabetes. If there is no underlying cause, simple hygiene measures, mild painkillers and the avoidance of tugging the foreskin are the only necessary treatments. Most cases will recover without further intervention.

Circumcision is only done for recurrent and troublesome cases.

This condition is caused by pulling back the foreskin behind the coronal ridge of the glans or head of the penis, without its subsequent replacement to its normal position.

The foreskin then forms a tight tourniquet around the glans, causing severe pain. The condition can sometimes be treated by firmly but gently squeezing the trapped glans until the foreskin can slip over it again
. If this is not possible, the paraphimosis needs to be reduced under a general anaesthetic.

Circumcision is not usually performed at this stage because of the associated inflammation, but may be required later if the foreskin remains tight.


SEATTLE, March 13 (UPI)

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