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To perform a meta-analysis exploring the association between male circumcision and HPV is a methodological challenge. Studies show a great variability in methodological issues such as circumcision status ascertainment, genital sites sampled, HPV-related outcome definition (HPV infection versus clinical lesion), procedures used to ascertain the outcome (clinical exam, penoscopy, acetoacid-staining, etc.), and, for HPV detection the collection device and the assay used to detect HPV DNA. At the statistical level both a meta-analysis using the adjusted odds ratios (OR) as published in each study and a stratified meta-analysis showing results by groups of studies that are homogenous in one of the above-listed methodological aspects is required in order to strictly adjust for potential confounders.

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