Circumcision could prevent prostate cancer

Circumcision could prevent prostate cancer ... if it’s performed after age 35, study shows

Researchers at the University of Montreal and the INRS-Institut-Armand-Frappier have shown that men circumcised after the age of 35 were 45% less at risk of later developing prostate cancer than uncircumcised men. This is one of the findings that resulted from a study undertaken by Andrea Spence and her research directors Marie-Élise Parent and Marie-Claude Rousseau. The researchers interviewed 2114 men living on the Island of Montreal. Half of them had been diagnosed with prostate cancer between 2005 and 2009, while the others participated in the study as the control group. The questions covered their lifestyle and medical history, if they were circumcised, and if so, the age at which the operation had been performed.37

Greater benefit for Black men

Across the board, the participants who were circumcised were 11% less likely to later develop a prostate cancer compared to those who weren't. The size of the reduction is not statistically significant. "This proportion reflects what has been shown in other studies," Parent explained. However, babies who were circumcised before the age of one were 14% less likely to develop prostate cancer. Moreover, the removal of the foreskin at a young age provides protection, over the long term, against the most aggressive forms of cancer.

Prostate cancer is rare amongst Jewish or Muslim men, the majority of whom are circumcised. While the specific causes of this cancer remain unknown, three risk factors have been identified: aging, a family history of this cancer, and Black African ethnic origins.

Amongst the 178 Blacks who took part in the study -- of whom 78% were of Haitian origin -- the risk of prostate cancer was 1.4 times higher than amongst Whites. 30% of the Black men were circumcised compared to 40% of the White men. Interestingly, the protective effect of the circumcision was limited to the Black men, whose risk of developing prostate cancer was decreased by 60%, with a very significant statistical effect.

Circumscribing the discovery

Researchers do not know what mechanism enables circumcision to protect men from prostate cancer. However, many studies have shown that this operation reduces the risk of acquiring a sexually transmitted infection (STI). "Unlike the skin that covers our bodies, the inner surface of the foreskin is composed of mostly non-keratinized mucosal epithelium, which is more easily penetrated by microbes that cause infections," Parent explained. Removing the foreskin could therefore reduce the risk of an infection that might be associated with prostate cancer.

In any case, the protective effect of circumcision (in particular the effect observed in the Black population) must be confirmed by other studies, especially in consideration of the relatively few Black men who participated in research.

Does Circumcision Remove The Most Sensitive Parts Of The Penis?

By: UroToday
Source: Science Daily

The most common medical procedure in the US is infant male circumcision. The long-term-health impact of neo-natal circumcision has received little study while the consequences of circumcision on sexual function in the adult male have received even less attention.

A recent study by M. Sorrels and colleagues from the National Organization of Circumcision Information Resource Center and Michigan State University mapped the fine-touch pressure thresholds of the adult male penis in circumcised and uncircumcised men and compared the two populations. The study is published in the April 2007 issue of BJU Int.adorable baby girl together with her mother 23 2148529149

Adult male volunteers were evaluated with a 19 point Semmes-Weinstein monofilament touch-test to map fine-touch pressure thresholds of the penis. Circumcised and uncircumcised men were compared using mixed models for repeated data, controlling for age, type of underwear worn, time since test ejaculation, ethnicity, country of birth, and level of education.

Analysis of results showed the glans of the uncircumcised men had significantly lower thresholds than that of circumcised men (P = 0.040). There were also significant differences in pressure thresholds by location on the penis (p < 0.0001). The most sensitive location on the circumcised penis was the circumcision scar on the ventral surface. It was remarkable that five locations on the uncircumcised penis that are routinely removed at circumcision had lower pressure thresholds that the ventral scar of the circumcised penis.

This study suggests that the transitional region from the external to the internal prepuce is the most sensitive region of the uncircumcised penis and more sensitive than the most sensitive region of the circumcised penis. It appears that circumcision ablates the most sensitive parts of the penis.

Neonatal circumcision does not reduce penile sensitivity in men, study finds

By: Elsevier Health Sciences
Source: Science Daily

Few data are available concerning the consequences of neonatal circumcision on penile sensitivity in adults. New research reported in The Journal of Urology® indicates that there are no differences in penile sensitivity for a variety of stimulus types and penile sites between circumcised and intact men. Additionally, this study challenges past research suggesting that the foreskin is the most sensitive and, in turn, most sexually relevant, part of the adult penis.

When the American Academy of Pediatrics and Canadian Pediatric Society recently revised their policies concerning routine neonatal circumcision, public interest was reignited in this long-running debate. Focusing on health outcomes, particularly protection against sexually transmitted infections, rather than penile sensitivity, the American policy statement supports routine circumcision of newborn males, while the Canadian policy does not.

Investigators examined two hypotheses that might support decreased penile sensitivity: whether the exposed glans penis of circumcised men is less sensitive than that of intact men (where keratinization is hypothesized to take place), and if the highly innervated foreskin is more sensitive than other sites of the penis.adorable blonde baby sitting floor 58409 9612

"We directly tested whether circumcision is associated with a reduction in penile sensitivity by testing tactile detection, pain, warmth detection, and heat pain thresholds at multiple sites on the penis between groups of healthy (neonatally) circumcised and intact men," explained lead author Jennifer Bossio, PhD candidate in Clinical Psychology of the Department of Psychology, Queen's University, Ontario, Canada (working with Dr. Caroline Pukall, PhD, and Dr. Stephen Steele, MD). "This study indicates that neonatal circumcision is not associated with changes in penile sensitivity and provides preliminary evidence to suggest that the foreskin is not the most sensitive part of the penis."

Sixty-two men between the ages of 18 and 37 (30 circumcised, 32 intact) participated in the study. Quantitative sensory testing (QST) protocols assessed touch and pain thresholds and warmth detection and heat pain thresholds at a control site (forearm) and three to four penile sites (glans penis, midline shaft, proximal to midline shaft, and foreskin, if present). The authors reported that the pain, warmth detection, and heat pain stimuli likely activate nerve fibers more relevant to sexual pleasure than touch thresholds, which has been the focus of previous research.

Although in a previous study lower tactile thresholds were noted at the glans penis in circumcised men, the current investigation found no between-group differences in sensitivity across four stimulation types, lending no support to the widely accepted, but largely untested, keratinization hypothesis.

The investigators also found that the foreskin had similar sensitivity as the control site on the forearm for any stimulus type tested. Given that other genital sites (e.g., glans penis, midline shaft) were more sensitive to pain stimuli than the forearm, removing the highly innervated foreskin does not appear to remove the most sensitive part of the penis.

Sexual function was assessed via the International Index of Erectile Functioning (IIEF), a 15-item measure of men's sexual functioning over the past four weeks across the five domains of erectile function: intercourse satisfaction, orgasmic function, sexual desire, and overall satisfaction. No differences between the groups were observed on any of these measures, suggesting that sexual functioning may not differ across circumcision status.

"Methodology and results from this study build on previous research and imply that if sexual functioning is related to circumcision status, this relationship is not likely the result of decreased penile sensitivity stemming from neonatal circumcision," observed Ms. Bossio.

Male Circumcision Reduces HIV Risk: No Further Evidence Needed, According To Review

By: Wiley - Blackwell

Three recent African trials support male circumcision for reducing the risk of contracting HIV in heterosexual men. After including new data from these trials in their review, Cochrane Researchers have changed their previous conclusions that there was insufficient evidence to recommend circumcision as an intervention to prevent HIV infection in heterosexual men.36

"Research on the effectiveness of male circumcision for preventing HIV in heterosexual men is conclusive. No further trials are required to establish that HIV infection rates are reduced in heterosexual men for at least the first two years after circumcision," says lead researcher Nandi Siegfried, Co-director of the South African Cochrane Centre at the South African Medical Research Council. "Policy makers can consider implementing circumcision as an additional measure into HIV prevention programmes."

Circumcision may help to protect against HIV by removing cells in the foreskin to which the virus is specifically attracted. Called Langerhans cells, they display receptors that enable HIV entry. Previous non-randomised studies investigated the association between circumcision and HIV, but until now, Cochrane researchers have been unable to make strong recommendations for the intervention due to a lack of high quality evidence gained from randomised clinical trials.

The clinical trials included in the review took place in South Africa, Uganda, and Kenya between 2002 and 2006, and included a total of 11,054 men. The results show that circumcision in heterosexual men significantly reduces their risk of acquiring HIV by 54% over a two year period, compared with uncircumcised men. This reduced risk is the best estimate of the average effect and the researchers report that the true risk will be reduced by between 38 to 66%. Further research, however, is required to establish whether male circumcision offers any benefit to women partners of circumcised men and homosexual men.

The researchers warn that policy makers also need to think about the culture and environment in which circumcision is carried out. "In many countries, male circumcision is practiced as part of the rites of initiation by traditional healers who are not trained in aseptic surgical techniques. So adverse events following traditional circumcisions can be high," says Siegfried.

What to know about HIV false-positives

By: Medically reviewed by Daniel Murrell, M.D. — Written by Jayne Leonard
Source: Medical News Today

A false-positive HIV test occurs when a test incorrectly indicates that a person has contracted the virus. Receiving a false positive can inspire conflicting feelings. People may wonder what they can or should do next.

In this article, we suggest some next steps for people who have had false-positive HIV test results. We also provide detailed information about the HIV testing process.

A person knows that they have had a false positive when an initial test indicated that they had HIV but a follow-up test was negative.

A false positive typically results from the test incorrectly identifying non-HIV antibodies as HIV antibodies.
What to do after a false-positive result
A person may want to seek support after a false-positive result.

After receiving the initial result, the healthcare provider will perform an additional test to ensure that the result is accurate.34

If the second result is also positive, it confirms the presence of HIV.

In this case, a healthcare provider will provide support and information about treatment options.

If the follow-up test is negative, it means that the first test was incorrect.

Below are some tips that can help a person deal with a false-positive result.
Seek support

When a person learns that they may have a chronic condition, it can be stressful or overwhelming, even while waiting to receive the results of the second test.

If the second test returns a negative result, a person may experience conflicting emotions. It can be helpful to seek support during this time, from family, friends, or a partner.

Some people may wish to discuss their emotions with a mental health professional, such as a therapist.
Find the reason for the result

It is important to discuss the cause of a false-positive result with the doctor.

Some false positives stem from technical mix-ups, incorrect labeling, or a person misreading the result.

There can also be medical mechanisms behind false positives.

For example, a false-positive reading may indicate that the person has an autoimmune disorder or another underlying medical condition. In this case, it may be a good idea to investigate further.
Consider repeating the test in a few months

If a person receives a negative follow-up result but thinks that they may have been exposed to the virus in recent weeks, it is important to take another test in 2–3 months.

This is because it takes several weeks for HIV antibodies to reach detectable levels in the bloodstream.

Doctors call the time in which levels of antibodies are undetectable the “window period.” HIV test results are often negative during this period, though the person has contracted the virus.

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