Male Sexual Behavior and Human Papillomavirus DNA: Key Risk Factors for Cervical Cancer in Spain

Bosch, F. Xavier; Castellsagué, Xavier; Muñóz, Núbia; Sanjosé, Sílvia de; Ghaffari, Anthony M.; González, Luis; Gili, M; Izarzugaza, Isabel; Viladiu, P.; Navarro, Carmen; Vergara, A; Ascunce, Nieves; Guerrero, E; Shah, Keerti V.

doi:10.1093/jnci/88.15.1060

Cited by 217 publications

(125 citation statements)

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“…Data on men's attitudes and knowledge is less common. However, one study demonstrated a five-fold increased risk of cervical cancer in women who had a male partner infected with penile HPV (Bosch et al, 1996). Furthermore, extramarital partners and number of lifetime partners in males is also associated with HPV detection and increased risk for cervical cancer in female partners (Zunzunegui et al, 1986;Burk et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

An Exploratory Study of Japanese Fathers' Knowledge of and Attitudes towards HPV and HPV Vaccination: Does Marital Status Matter?

Hanley¹,

Yoshioka²,

Ito³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: No studies on male attitudes towards HPV and HPV vaccination have been conducted in Japan, and little is known globally whether attitudes of single fathers differ to those living with a female partner. This exploratory study assessed whether Japanese fathers were likely to have their daughter vaccinated against HPV in a publically funded program and whether any differences existed regarding attitudes and knowledge about HPV according to marital status. Materials and Methods: Subjects were 27 fathers (16 single; 11 married) who took part in a study on HPV vaccine acceptability aimed at primary caregivers of girls aged 11-14 yrs in three Japanese cities between July and December 2010. Results: Knowledge about HPV was extremely poor (mean score out of 13 being 2.74±3.22) with only one (3.7%) participant believing he had been infected with HPV and most (81.4%) believing they had no or low future risk. No difference existed regarding knowledge or awareness of HPV according to marital status. Concerning perceived risk for daughters, single fathers were significantly more likely to believe their daughter was at risk for both HPV (87.5% versus 36.4%; p=0.01) and cervical cancer (75.0% versus 27.3%; p=0.02). Acceptability of free HPV vaccination was high at 92% with no difference according to marital status, however single fathers were significantly more likely (p=0.01) to pay when vaccination came at a cost. Concerns specific to single fathers included explaining the sexual nature of HPV and taking a daughter to a gynecologist to be vaccinated. Conclusions: Knowledge about HPV among Japanese fathers is poor, but HPV vaccine acceptability is high and does not differ by marital status. Providing sexual health education in schools that addresses lack of knowledge about HPV as well as information preferences expressed by single fathers, may not only increase HPV vaccine acceptance, but also actively involve men in cervical cancer prevention strategies. However, further large-scale quantitative studies are needed.

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Section: Introductionmentioning

confidence: 99%

An Exploratory Study of Japanese Fathers' Knowledge of and Attitudes towards HPV and HPV Vaccination: Does Marital Status Matter?

Hanley¹,

Yoshioka²,

Ito³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…2 HPV infection in men causes genital warts, 3 and is associated with HPV infection 4,5 and cervical cancer 6,7 in female partners.…”

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Prevalence and determinants of human papillomavirus infection in men attending vasectomy clinics in Mexico

Vaccarella

Lazcano‐Ponce

Castro-Garduño

et al. 2006

Intl Journal of Cancer

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Large studies of genital human papillomavirus (HPV) infection in men are few and mainly include high-risk groups. We interviewed 779 men who requested a vasectomy in 27 public clinics in 14 states of Mexico. Exfoliated cells were obtained from the scrotum, the shaft of the penis, the top of the penis including the coronal sulcus, the glans and the opening of the meatus. HPV testing was performed using biotinylated L1 consensus primers and reverse line blot. Unconditional logistic regression was used to estimate odds ratios (ORs) of being HPV-positive and corresponding 95% confidence intervals (CIs). The prevalence of any type of HPV was 8.7%. HPV positivity was highest among men below age 25 (13.6%), and lowest among men aged 40 years or older (6.0%). The most commonly found HPV types were, in decreasing order, HPV59, 51, 6, 16 and 58. Lifetime number of sexual partners was associated with HPV positivity (OR for 4 vs. 1 partner 5 3.7, 95% CI: 2.0-6.8), mainly on account of the strong association with number of occasional and sex-worker partners. Condom use with both regular (OR 5 0.4, 95% CI: 0.1-1.0) and sex-worker (OR 5 0.1, 95% CI: 0.0-0.3) partners and circumcision (OR 5 0.2, 95% CI: 0.1-0.4) were inversely associated with HPV positivity. HPV prevalence in Mexican men was similar to the prevalence found in Mexican women of the same age groups. The association between HPV positivity and lifetime number of sexual partners in the present low-risk male population is one of the strongest ever reported in studies in men. Condom use and circumcision were associated with a strong reduction in HPV prevalence. ' 2006 Wiley-Liss, Inc.Key words: human papillomavirus; men; Mexico; sexual habits; condom use Human papillomavirus (HPV) infection, the necessary cause of invasive cervical cancer and its precursor lesions, 1 is a very common sexually transmitted disease in women in many populations. 2 HPV infection in men causes genital warts, 3 and is associated with HPV infection 4,5 and cervical cancer 6,7 in female partners.Previous studies on genital HPV infection in men showed an approximately equal prevalence of HPV infection in any population in the 2 genders, 8 and the existence of a direct, though moderate, association between HPV positivity among men and lifetime number of sexual partners. 9,10 However, contrary to the relatively large amount of information on genital HPV infection in women, 2,11 large studies on HPV prevalence in the general male population are few. Furthermore, the majority of studies in men have focused on young individuals 12 or high-risk populations [e.g., men attending sexually transmitted disease (STD) clinics 9,13,14 or enrolled in military service [15][16][17] ].Two previous reports from Mexico 12,17 showed that more than one-third of the young men studied were infected with genital HPV. To further elucidate the characteristics of HPV infection in the general male population, we assessed the prevalence and determinants of infection with 35 HPV types among 779 Mexican men who attended publi...

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“…Human papillomavirus has also been linked to cancers of the vulva, vagina, anus, and penis (IARC 1995;Melbye and Frisch, 1998). Genital HPV types are transmitted sexually and the risk of infection has been associated with numerous parameters involving sexual behaviour (Franco et al, 1995;Bosch et al, 1996;Kjaer et al, 2001).Partner studies have shown that penile lesions are found in more than half of the male partners of women with cervical intraepithelial neoplasia (CIN) (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Bleeker et al, 2002). Flat lesions are reported as the most prevalent lesion type and their relationship with HPV has been established (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Hippelainen MI et al, 1993b;Bleeker et al, 2002).…”

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HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

et al. 2005

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We earlier demonstrated, in a randomised clinical trial, that the regression time of flat penile lsions in male sexual partners of women with cervical intraepithelial neoplasia (CIN) was shorter in men who used condoms compared to those who did not. To further evaluate this finding, we examined whether the effect of condom use on the regression of flat penile lesions depends on the presence of human papillomavirus (HPV) type concordance in sexual couples, as determined in cervical and penile scrapes by GP5 þ /6 þ PCR testing. A Cox model with time-dependent covariates showed a beneficial effect of condoms on regression of flat penile lesions in concordant couples (hazard ratio 2.63, 95% CI 1.07 -6.48) but not in those who were nonconcordant. When both partners harboured different HPV types, no effect of condoms was found (hazard ratio 0.90, 95% CI 0.27 -2.96). Delayed regression of flat penile lesions was associated with either stable lesions or with new penile lesions developing at sites surrounding pre-existing lesions suggesting reinfection of the penile epithelium. We conclude that condom use blocks sexual HPV transmission by preventing reinfection and development of new penile lesions in men who are susceptible to the same type as present in the female partner. Infection with high-risk types of human papillomavirus (HPV) is the major cause of cervical cancer and its precursor lesions (Schiffman et al, 1993;Walboomers et al, 1999;Bosch et al, 2002;Munoz et al, 2003). Human papillomavirus has also been linked to cancers of the vulva, vagina, anus, and penis (IARC 1995;Melbye and Frisch, 1998). Genital HPV types are transmitted sexually and the risk of infection has been associated with numerous parameters involving sexual behaviour (Franco et al, 1995;Bosch et al, 1996;Kjaer et al, 2001).Partner studies have shown that penile lesions are found in more than half of the male partners of women with cervical intraepithelial neoplasia (CIN) (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Bleeker et al, 2002). Flat lesions are reported as the most prevalent lesion type and their relationship with HPV has been established (Barrasso et al, 1987;Campion et al, 1988;Hippelainen M et al, 1991;Hippelainen MI et al, 1993b;Bleeker et al, 2002). Since flat penile lesions are only well visible after acetowhitening, their presence remains often unnoticed. This explains why the natural history of penile lesions and HPV infection in men has not been studied extensively and is largely unknown.We have recently shown that the presence of penile HPV is associated with delayed regression whereas condom use revealed accelerated regression . The beneficial effect of condom intervention on regression of penile lesions suggests that a sexual transmittable factor, that is, most likely cervical HPV, influences the clinical course of these lesions. To evaluate this hypothesis, the effect of condom use on regression of flat penile lesions was studied in relation to the presence of HPV type concordance between sexual part...

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Male Sexual Behavior and Human Papillomavirus DNA: Key Risk Factors for Cervical Cancer in Spain

Abstract: Men who report multiple sexual partners or who are carriers of HPV DNA may be vectors of high-risk HPV types and may place their wives at high risk of developing cervical cancer. Prostitutes are an important reservoir of high-risk HPVs.

Cited by 217 publications

References 30 publications

An Exploratory Study of Japanese Fathers' Knowledge of and Attitudes towards HPV and HPV Vaccination: Does Marital Status Matter?

An Exploratory Study of Japanese Fathers' Knowledge of and Attitudes towards HPV and HPV Vaccination: Does Marital Status Matter?

Prevalence and determinants of human papillomavirus infection in men attending vasectomy clinics in Mexico

HPV type concordance in sexual couples determines the effect of condoms on regression of flat penile lesions

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