The Association of Circumcision and Prostate Cancer: A Meta-Analysis.

BACKGROUND To investigate any association between circumcision and prostate cancer. MATERIALS AND METHODS We searched PubMed, EMBASE, the Cochrane Library, and Chinese biomedicine literature databases up to August 2015. All case-control studies were identified which investigated associations of circumcision with prostate cancer. Three authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.3 and STATA version 11.0. RESULTS Six case-control studies met the inclusion criteria. The pooled meta-analysis showed that there was a lower incidence of circumcision in prostate cancer patients compared with controls (OR=0.90, 95% con dence interval [CI] 0.82-0.98, P=0.01). The results of meta-analysis also showed that no significant difference was found between circumcision and less aggressive prostate cancer (OR=0.93, 95% CI 0.83-1.04, P=0.19); however, there was a lower incidence of circumcision in more aggressive prostate cancers compared with controls (OR =0.84, 95% CI 0.72-0.97, P=0.02). The Egger's results did not show any evidence of publication bias(P=0.798). CONCLUSIONS In summary, within the limits of available data, males with circumcision appears to have a lower incidence of prostate cancer. In the future, high-quality multicenter studies are needed to thoroughly verify the outcome.