Men had a 15% lower risk of prostate cancer if they had been circumcised before first sexual intercourse, data from two case-control studies showed.
Circumcised men had a lower prevalence of both less and more aggressive forms of prostate cancer.
The findings lend credence to evidence linking sexually transmitted infections (STIs) to prostate cancer etiology, investigators reported online in Cancer.
“Infection and inflammation in the prostate may be important mechanisms that enhance the risk of subsequent development of prostate cancer in some men,” Jonathan L. Wright, MD, of the University of Washington in Seattle, and co-authors wrote. “There is growing evidence to support a role for STIs in prostate cancer etiology.”
“Recent work has also shown that circumcision reduces risk for acquiring STIs,” they added. “We found a 15% reduction in the relative risk of prostate cancer in men circumcised before their first sexual intercourse, suggesting a biologically plausible mechanism through which circumcision may decrease the risk of prostate cancer.”
Infection has a well-established role in cancer etiology. Several potential mechanisms have plausibility, including direct cellular transformation by viruses and inflammation-induced changes in cellular microenvironment.
Multiple studies have implicated STIs in prostate cancer etiology, including a large meta-analysis that showed a 50% higher risk of prostate cancer in men with any history of STI (Fam Med 2005; 37: 506-512). Moreover, several organisms associated with STIs have been isolated from prostate tissue, including bacteria and viruses, according to the introduction to the article.
Studies also have shown a reduced risk of STIs in circumcised men.
“Therefore, if we assume that STIs play a role in prostate cancer, and accept that circumcision can reduce the incidence of STIs, it is then plausible that circumcision may also reduce the risk of prostate cancer,” the authors wrote.
To examine the mechanistic plausibility in a large group of men, the authors analyzed data from two case-control studies involving 3,400 men. One of the studies demonstrated a nonsignificant 14% reduction in prostate cancer risk in circumcised men (Am J Epidemiol 2001; 153: 1152-1158).
AMOXICILLIN is one of the most commonly used antibiotics in the world. It belongs to the spectrum of β-lactam antibiotics, and is the drug of choice when it comes to treating bacterial infections, as it is well absorbed even when given orally. Hence, it is used to treat a variety of infections, including infections of the ear, nose throat, skin infections, urinary tract infections, lower respiratory tract infections, gonorrhea and other sexually transmitted infections etc. AMOXICILLIN for sinus infection treatment is also a very well-known use of this drug. Thus, its multipurpose use makes this drug a very popular one among medical practitioners. However, amoxicillin side effects are something that doctors need to be well aware of, so as to prevent them from occurring, as they can be life-threatening at times.
One of the most serious and dangerous of all side effects is anaphylactic reaction. An anaphylactic reaction is defined as a life-threatening type 1 hypersensitivity reaction to a drug which is given internally or orally. Around 1500 patients die yearly due to an anaphylactic reaction in the United States. However, this serious allergic response of the body only occurs in those patients that have a true allergy to penicillin and its derivatives, as opposed to people who present with pseudo-anaphylaxis or an anaphylactoid reaction. An anaphylactic reaction is characterized by the following signs and symptoms:
– Normally, a true anaphylactic reaction with systemic signs and symptoms begin showing within 72 hours of exposure to the allergen, without the need of further exposure. Skin involvement is one of the first signs seen. This includes generalized hives, skin rashes, itchiness, flushing. Fever is often experienced by people, along with the skin rashes.
– Swelling of lips, tongue and/or throat is also seen, as this is the body’s way of responding and fighting the inflammation.
– Respiratory distress, in the form of difficulty in breathing, shortness of breath, wheezing etc. may also be seen.
– Some patients may also complain of gastrointestinal problems like severe abdominal cramps, stomach pain, diarrhea etc.
– Other serious effects that may occur if immediate action is not taken to deal with the symptoms includes coronary artery spasms, which may lead to myocardial infarction. Consequently, there may also be a sudden drop in blood pressure, which may lead to lightheadedness and fatigue, along with loss of consciousness.
The analysis comprised 1,754 men with a history of prostate cancer and a control group of 1,645 men.
Evaluation of baseline characteristics showed that the cases had a higher rate of prostatitis (12.5% versus 8%, P<0.001) and were more likely to have a family history of prostate cancer (20.9% versus 10.8%, P<0.001). The groups did not differ with respect to history of STIs.
The analysis showed that 1,139 (64.5%) prostate cancer patients and 1,135 (69%) men in the control group underwent circumcision before first sexual intercourse. The difference translated into a prostate cancer odds ratio of 0.85 in favor of the control group.
The authors also analyzed the data according to prostate cancer aggressiveness, defining aggressive cancer as Gleason score ≥7, nonlocalized stage at diagnosis, or PSA >20 ng/mL at diagnosis.
The resulting odds ratios for the control group versus cases were 0.88 for less aggressive cancer and 0.82 for more aggressive disease.
The authors acknowledged their reliance on self-reported information about STIs and circumcision as the most obvious limitation of the study.
The study was supported by the National Institutes of Health and and Fred Hutchinson Cancer Research Center.
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Primary source: Cancer
Source reference: Wright JL, et al “Circumcision and the risk of prostate cancer” Cancer 2012; DOI:10.1002/cncr.26653.
