Circuncisão por motivos médicos no sistema público de saúde do Brasil: epidemiologia e tendências

Korkes, Fernando; Ii, Jarques Lucio Silva; Pompeo, Antônio Carlos Lima

doi:10.1590/s1679-45082012000300015

Cited by 11 publications

(5 citation statements)

References 13 publications

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“…Large nationally representative surveys were more likely to provide the most accurate estimates of MC prevalence, whereas small surveys in sub-regions of a country have the potential to generate MC prevalence data that deviate from the actual national figure. As an example, a more recent, larger national survey in Brazil found overall MC prevalence to be 1.3 % [ 48 ], noting higher figures for cities in the south compared with rural areas in the north of this country. This demonstrated that MC prevalence figures from older surveys confined to Sao Paulo [ 50 – 52 ] and Rio de Janeiro [ 49 ] had yielded figures higher than the national average.…”

Section: Discussionmentioning

confidence: 99%

Estimation of country-specific and global prevalence of male circumcision

Morris

Wamai

Henebeng

et al. 2016

Popul Health Metrics

151

116

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BackgroundMale circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence.MethodsMC prevalence data were obtained by searches in PubMed, Demographic and Health Surveys, AIDS Indicator Surveys, and Behavioural Surveillance Surveys. Male age was ≥15 years in most surveys. Where no data were available, the population proportion whose religious faith or culture requires MC was used. The total number of circumcised males in each country and territory was calculated using figures for total males from (i) 2015 US Central Intelligence Agency (CIA) data for sex ratio and total population in all 237 countries and territories globally and (ii) 2015 United Nations (UN) figures for males aged 15–64 years.ResultsThe estimated percentage of circumcised males in each country and territory varies considerably. Based on (i) and (ii) above, global MC prevalence was 38.7 % (95 % confidence interval [CI]: 33.4, 43.9) and 36.7 % (95 % CI: 31.4, 42.0). Approximately half of circumcisions were for religious and cultural reasons. For countries lacking data we assumed 99.9 % of Muslims and Jews were circumcised. If actual prevalence in religious groups was lower, then MC prevalence in those countries would be lower. On the other hand, we assumed a minimum prevalence of 0.1 % related to MC for medical reasons. This may be too low, thereby underestimating MC prevalence in some countries.ConclusionsThe present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world. We estimate that 37–39 % of men globally are circumcised. Considering the health benefits of MC, these data may help guide efforts aimed at the use of voluntary, safe medical MC in disease prevention programs in various countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0073-5) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Estimation of country-specific and global prevalence of male circumcision

Morris

Wamai

Henebeng

et al. 2016

Popul Health Metrics

151

116

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“…This is because of the low prevalence of circumcision in the general population (<20%) 36 . Neonatal circumcision is not normally performed in Brazil, and regions with worse access to healthcare have a lower rate of circumcision in childhood and adulthood 37 . By comparison, in the United States, where around 80.5% of the global population is circumcised, the incidence of penile cancer is very low 38 .…”

Section: Discussionmentioning

confidence: 99%

Profile of patients with penile cancer in the region with the highest worldwide incidence

Vieira

Feitoza

Pinho

et al. 2020

Sci Rep

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To determine the epidemiological, histopathological, and clinical characteristics of patients diagnosed with penile cancer in the Brazilian state of Maranhão, the region with the highest incidence worldwide. One hundred and sixteen penile cancer patients were interviewed from July 2016 to October 2018. The majority of patients lived in a rural area (57%), worked in farming (58%), had a low level of schooling or no schooling (90%), and were married or in a stable relationship (74%). The mean age was 60.4 ± 16.51 years (range, 23-93 years). Phimosis (66%), poor/moderate genital hygiene (73%), history of sexually transmitted infections (55%), and zoophilia (60%) were found in the majority of patients. Most patients had their first sexual encounter at 16.2 ± 2.8 years (range, 10-25 years), and 75% had >6 sexual partners. The most common initial symptom was pruritus (37%), and most patients waited to seek treatment (average time to treatment, 18.9 months; range, 2-84 months). Human papillomavirus (HPV)-related histologies were observed in 62% of patients. Most patients had histological grades II or III (87%), stage ≥T2 disease (84%), and lymphadenopathy at admission (42%). Penectomy was performed in 96% of patients. The population with penile cancer in the region of highest incidence in the world is marked by low socioeconomic status, high prevalence of HPV infection, and phimosis. The delay in seeking treatment is related to a very high rate of advanced cancer and aggressive surgical treatment. The high prevalence of young patients was also a striking feature.Penile cancer is uncommon in developed countries, and its incidence varies according to the demographic region and the circumcision status 1,2 . In the US and Europe, the age-standardized incidence rate (ASR) for 100,000 inhabitants is between 0.1 and 1.0 3 . However, in less developed countries, including some countries in South America, Asia, and Africa, the incidence is alarmingly high 1 . In uncircumcised males, the cumulative lifetime risk for cancer of the penis is higher compared to the general population, corresponding to 1 in 600 men in the US 2 . Brazil has a high incidence, and the state of Maranhão, located in the northeastern region of the country, has the highest incidence of penile cancer in the world (ASR of 6.1 cases per 100,000 inhabitants) 4 .The etiology of penile carcinoma remains unknown, and its mechanisms of development have not been completely elucidated. Phimosis, balanitis, smegma, precarious genital hygiene, smoking, history of sexually transmitted infections (STIs), and human papilloma virus (HPV) infection (present in approximately 50% of cases) are the main risk factors, and circumcision is an important protective factor 5-8 . Its incidence is higher in regions History of STIs 55 (40/73) Sexual history Age of first sexual encounter [mean (range)] 16.2 years (10-25 years) Zoophilia 60 (43/72) No. female partners Less than 6 25 (19/75) Between 6 and 10 17 (13/75) More than 10 58 (43/75) Duration of symptom [mean (range)] 18.9 months ...

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“…When age was limited to 1 to 4 years, it was noted that 1.1% of these children were circumcised within this period. 2 …”

Section: Introductionmentioning

confidence: 99%

Circumcision: postoperative complications that required reoperation

Talini¹,

Antunes²,

Carvalho³

et al. 2018

Einstein (São Paulo)

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Objective To evaluate post-operative complications of circumcision requiring surgical reintervention.Methods Retrospective analysis of medical records of patients submitted to circumcision from May 1st, 2015 to May 31st, 2016.Results A total of 2,441 circumcisions were performed; in that, 1,940 using Plastibell and 501 by the classic technique. Complications requiring surgical reintervention were found in 3.27% of patients. When separated by surgical technique, 3.4% of circumcisions using Plastibell device required reoperation, as compared to 3% of conventional technique (p=0.79). Preputial stenosis was most frequently found in classic circumcision, with statistical significance (p<0.001). Bleeding was more frequent when using Plastibell device, but the difference was not statistically different (p=0.37). Patients’ age was also evaluated to investigate if this variable influenced on the postoperative outcome, but no significant difference was found.Conclusion There was no statistically significant difference when comparing complications between the different techniques performed at this hospital. Preputial stenosis was most frequently found in the classic circumcision, while bleeding was more prevalent when using Plastibell device. Patients’ age did not influence in complications.

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Circuncisão por motivos médicos no sistema público de saúde do Brasil: epidemiologia e tendências

Cited by 11 publications

References 13 publications

Estimation of country-specific and global prevalence of male circumcision

Estimation of country-specific and global prevalence of male circumcision

Profile of patients with penile cancer in the region with the highest worldwide incidence

Circumcision: postoperative complications that required reoperation

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