The evidence continues to grow that circumcision may help lower a man’s overall risk for prostate cancer. However, it may be a bit too soon to universally recommend circumcision as a means of lowering prostate cancer risk. An observational study that included 1,590 patients with prostate cancer and 1,618 controls is suggesting that circumcised men have a slightly lower risk of prostate cancer than uncircumcised men.1
The study, which was published in BJU International, was conducted in Montreal and all the men were diagnosed between 2005 and 2009. The population-based case-control study, which was called PROtEuS (Prostate Cancer and Environment Study), found that circumcision was protective in men circumcised after age 35. Among men circumcised within 1 year of birth, the procedure decreased the risk by 14%; when the procedure was performed after age 35, the risk decreased by 45%.
“We found that circumcision before the age of 1 and after the age of 35 were associated with a reduced risk of prostate cancer, although only results for the latter group were statistically significant,” said study investigator Marie-Élise Parent, PhD, of the University of Quebec’s INRS-Institut Armand-Frappier in Quebec, Canada.
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She said the strongest protective effect of circumcision was observed in black men, who had a 60% reduced risk if they were circumcised. No association was found with other ancestral groups.
Dr. Parent said this is a particularly interesting finding since black men have the highest rates of prostate cancer worldwide and this has never been explained. This novel finding warrants further examination in future studies that have a larger number of black participants. The study included 178 black men and 78% were of Haitian origin.
Currently, advanced age, African ancestry, and family history are considered independent risk factors for prostate cancer. However, circumcision may be a procedure that is worth considering as a means of lowering prostate cancer incidence.
“Circumcision may reduce the risk of contracting and maintaining a sexually transmitted infection (STI), which has been postulated to be a risk factor for prostate cancer. This may explain the reduced risk of prostate cancer observed in males circumcised at a younger age prior to any potential exposure to STIs,” Dr. Parent told CancerTherapyAdvisor.com. “We do not know why a protective effect was observed for men circumcised after the age of 35. These men may have had a pathologic condition of the foreskin that led to them being circumcised.”
In March 2012, a study published in the journal Cancer found that circumcision before first sexual intercourse was associated with a 15% reduction in risk of prostate cancer compared with uncircumcised men.2 The study included 1,754 men with prostate cancer and 1,645 controls. The researchers hypothesized from their findings that an infectious/inflammatory pathway may be involved in the risk of prostate cancer in some men.