Table 2.
Association between circumcision and human papillomavirus (HPV) prevalence, by anatomic site
| Any HPV |
Oncogenic HPVb |
Nononcogenic/undetermined risk/unclassified HPVc |
Multiple HPV |
|||||
|---|---|---|---|---|---|---|---|---|
| Sitea | + | - | + | - | + | - | + | - |
| NOTE. Data are no. (%), unless otherwise indicated. CI, confidence interval; glans/corona, glans penis and coronal sulcus; NA, not applicable. | ||||||||
| Penis foreskin | … | … | … | … | … | … | … | … |
| Circumcised | NA | NA | NA | NA | NA | NA | NA | NA |
| Uncircumcised | 28 (44) | 35 (56) | 14 (29) | 35 (71) | 24 (41) | 35 (59) | 14 (29) | 35 (71) |
| Adjusted OR (95% CI)d | NA | NA | NA | NA | NA | NA | NA | NA |
| Glans/corona | 100 (32) | 208 (74) | 50 (19) | 208 (81) | 72 (26) | 208 (74) | 40 (16) | 208 (84) |
| Circumcised | 69 (29) | 172 (71) | 34 (16) | 172 (84) | 49 (22) | 172 (78) | 24 (12) | 172 (88) |
| Uncircumcised | 31 (46) | 36 (54) | 16 (31) | 36 (69) | 23 (39) | 36 (61) | 16 (31) | 36 (69) |
| Adjusted OR (95% CI)d | 1.97 (1.03-3.77) | 2.51 (1.11-5.69) | 1.92 (0.93-4.00) | 3.58 (1.50-8.50) | ||||
| Penile shaft | 175 (52) | 159 (48) | 84 (35) | 159 (65) | 143 (47) | 159 (53) | 71 (31) | 159 (69) |
| Circumcised | 133 (50) | 131 (50) | 67 (34) | 131 (66) | 107 (45) | 131 (55) | 55 (30) | 131 (70) |
| Uncircumcised | 42 (60) | 28 (40) | 17 (38) | 28 (62) | 26 (56) | 28 (44) | 16 (36) | 28 (44) |
| Adjusted OR (95% CI)d | 1.60 (0.82-2.37) | 1.43 (0.66-3.09) | 1.69 (0.86-3.34) | 1.74 (0.78-3.89) | ||||
| Urine | 20 (10) | 180 (91) | 3 (2) | 180 (98) | 18 (9) | 180 (91) | 2 (1) | 180 (99) |
| Circumcised | 13 (8) | 143 (90) | 2 (1) | 143 (99) | 11 (7) | 143 (99) | 0 (0) | 143 (100) |
| Uncircumcised | 7 (16) | 37 (84) | 1 (3) | 37 (97) | 7 (16) | 37 (84) | 2 (5) | 37 (95) |
| Adjusted OR (95% CI)d | 3.22 (0.86-12.13) | 5.42 (0.13-225.81) | 3.57 (0.91-14.00) | … | ||||
| Semen | 12 (6) | 185 (94) | 3 (2) | 185 (98) | 11 (6) | 185 (94) | 2 (1) | 185 (99) |
| Circumcised | 10 (6) | 143 (94) | 3 (2) | 143 (98) | 9 (6) | 143 (94) | 2 (1) | 143 (99) |
| Uncircumcised | 2 (5) | 42 (95) | 0 (0) | 42 (100) | 2 (5) | 42 (95) | 0 (0) | 42 (100) |
| Adjusted OR (95% CI)d | 0.92 (0.14-5.97) | … | 1.16 (0.17-7.76) | … | ||||
| Scrotum | 123 (40) | 187 (60) | 47 (20) | 187 (80) | 94 (33) | 187 (67) | 33 (15) | 187 (85) |
| Circumcised | 97 (40) | 148 (60) | 37 (20) | 148 (80) | 73 (33) | 148 (67) | 24 (14) | 148 (86) |
| Uncircumcised | 26 (40) | 39 (60) | 10 (20) | 39 (80) | 21 (35) | 39 (65) | 9 (19) | 39 (81) |
| Adjusted OR (95% CI)d | 1.22 (0.04-2.32) | 1.28 (0.54-3.03) | 1.45 (0.70-3.01) | 1.89 (0.75-4.77) | ||||
| External penise | 187 (59) | 129 (41) | 43 (25) | 129 (75) | 59 (31) | 129 (69) | 33 (20) | 129 (80) |
| Circumcised | 140 (57) | 106 (43) | 36 (25) | 106 (75) | 46 (30) | 106 (70) | 26 (20) | 106 (80) |
| Uncircumcised | 47 (67) | 23 (33) | 7 (23) | 23 (77) | 13 (36) | 23 (64) | 7 (23) | 23 (77) |
| Adjusted OR (95% CI)d | 1.72 (0.88-3.35) | 1.22 (0.42-3.54) | 1.65 (0.68-4.02) | 1.94 (0.64-5.87) | ||||
| External genitalsf | 194 (65) | 106 (35) | 43 (29) | 106 (71) | 59 (36) | 106 (64) | 33 (24) | 106 (76) |
| Circumcised | 146 (63) | 86 (37) | 36 (30) | 86 (70) | 46 (35) | 86 (65) | 26 (23) | 86 (77) |
| Uncircumcised | 48 (71) | 20 (29) | 7 (26) | 20 (74) | 13 (39) | 20 (61) | 13 (26) | 20 (74) |
| Adjusted OR (95% CI)d | 1.69 (0.85-3.39) | 1.16 (0.39-3.44) | 1.57 (0.64-3.90) | 1.85 (0.75-4.58) | ||||
| Any siteg | 201 (79) | 53 (21) | 66 (56) | 53 (44) | 86 (64) | 53 (38) | 35 (40) | 53 (60) |
| Circumcised | 153 (78) | 43 (22) | 52 (55) | 43 (45) | 66 (61) | 43 (39) | 28 (39) | 43 (61) |
| Uncircumcised | 48 (83) | 10 (17) | 14 (58) | 10 (42) | 20 (67) | 10 (33) | 7 (41) | 10 (59) |
| Adjusted OR (95% CI)d | 2.03 (0.78-5.28) | 2.62 (0.78-8.80) | 2.39 (0.80-7.14) | 2.85 (0.70-11.69) | ||||
Excludes specimens negative for β-globin and specimens from HIV-positive individuals. For foreskin, n = 63; for glans/corona, n = 308; for shaft, n = 334; for urine, n = 200; for semen, n = 197; for scrotum, n = 310.
Includes oncogenic/probable oncogenic types (HPV types 16, 18, 26, 31, 33, 35, 39, 45, 51-53, 56, 58, 59, 66, 68, 73, 82, and IS39); includes specimens concurrently positive for other types (nononcogenic, undetermined risk, and unclassified).
Includes nononcogenic types (HPV types 6, 11, 40, 42, 54, 61, 70, 72, 81, and CP6108) and types with undetermined risk status (HPV types 55, 62, 64, 67, 69, 71, 83, and 84); also includes specimens concurrently positive for oncogenic types.
Reference categories for all odds ratios (ORs) are HPV-negative circumcised men; ORs are adjusted for age, birthplace, race/ethnicity, education level, lifetime no. of female sex partners, history of sex with men, age at initial sex, condom use, history of genital warts, and history of cigarette smoking.
Glans/corona and/or shaft.
Glans/corona, shaft, and/or scrotum.
Glans/corona, shaft, scrotum, urine, and/or semen.