OBJECTIVES: To investigate the possible association between circumcision and prostate cancer (PCa) risk, to examine whether age at circumcision influences the PCa risk, and to determine whether race modifies the circumcision-PCa relationship.
SUBJECTS AND METHODS: PROtEuS, a population-based case-control study set amongst the mainly French-speaking population in Montreal, Canada, was used to address study objectives. The study included 1,590 pathologically confirmed PCa cases diagnosed in a Montreal French hospital between 2005 and 2009, and 1,618 population controls ascertained from the French electoral list, frequency-matched to cases by age. In-person interviews elicited information on sociodemographic, lifestyle and environmental factors. Unconditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) between circumcision, age at circumcision and PCa risk, adjusting for age, ancestry, PCa family history, PCa screening history, education, and history of sexually transmitted infections.
RESULTS: Circumcised men had a slightly lower risk, albeit not statistically significant, of developing PCa than uncircumcised men (OR 0.89, 95% CI 0.76-1.04). Circumcision was found to be protective in subjects circumcised after the age of 35 (OR 0.55, 95% CI 0.30-0.98). A weaker protective effect was observed among men circumcised within one year of birth (OR 0.86, 95% CI 0.72-1.04). The strongest protective effect of circumcision was recorded in Black men (OR 0.40, 95% CI 0.19-0.86, p-value for interaction 0.02) but no association was found with other ancestral groups.
CONCLUSION: Our findings provide novel evidence for a protective effect of circumcision against PCa development, especially to those circumcised after age 35; although, circumcision before the age of 1 may also confer protection. Circumcision appeared to be protective only among Black men, a group which has the highest rate of disease. Further research into the differences in effect of circumcision on PCa risk by ancestry is warranted, as is the influence of age at circumcision.
Written by:
Spence AR, Rousseau MC, Karakiewicz PI, Parent ME. Are you the author?
INRS-Institut Armand-Frappier, Université du Québec, Laval, Québec, Canada.
Reference: BJU Int. 2014 Mar 24. Epub ahead of print.
doi: 10.1111/bju.12741
PubMed Abstract
PMID: 24655933
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