Myken | http://www.savingsons.org/2013/07/circumcision-to-prevent-penile-cancer.ht...
http://www.savingsons.org/2013/07/circumcision-to-prevent-penile-cancer.html
Why do we always hear that circumcision reduces your chances of getting
penile cancer, but no one ever recommends female circumcision to reduce
the chances of vulvar cancer? Three times more women will get (external)
genital cancers, and three times more women will die from these this
year compared to men. [1-2]
Pro-circumcision fanatic, Edgar Schoen, would like us to believe that
penile cancer would drop significantly if all boys were circumcised, and
that if no one was circumcised, the penile cancer rate would double.
[3] Even if this were true, women would still be almost twice as likely
as men to get cancer in the external genitalia. Female circumcision,
then, would be more effective at reducing cancer rates than male
circumcision is.
Schoen also states that the statistics from Israel prove the benefits;
the penile cancer rate there is 0.1 per 100,000 compared to 1.0 per
100,000 in Denmark. We must always be careful with these kinds of
statistics because they can be misleading. Consider just one factor:
penile cancer incidence versus age distribution. Only 10.5% of Israel’s
population is over 65 years old [4], whereas 18% of Denmark’s population
is over 65 [5], and most penile cancer occurs in men over 65 [6]. This
one factor alone cuts the 10x benefit of circumcision in half. [7]
Another group of researchers published that intact men (in the same
demographic) were 3.2 times more likely to have penile cancer. [8]
However when we consider that circumcision removes about half of the
skin on the penis [9-10], we see that the benefit is only slightly
greater than the amount of tissue removed. The benefit provided by
circumcision is further reduced if phimosis is properly diagnosed and
treated. Phimosis is diagnosed in adults, not children [11]; it is a
condition where the foreskin does not retract to allow proper hygiene;
it affects about 1% of intact men [12]. Phimosis is easily treatable;
treatment costs are low, and most of the time surgical intervention is
unnecessary. [13-15] Another group of researchers suggests that phimosis
increases the risk of penile cancer by a factor of 16. [16] When
phimosis is factored out, intact men are actually half as likely to have
invasive penile cancer as circumcised men, as acknowledged by the
American Academy of Pediatrics:
In fact, in men with an intact prepuce and no phimosis, there is a
decreased risk of invasive penile cancer (OR: 0.5). [This] suggests that
the benefit of circumcision is conferred by reducing the risk of
phimosis. [17]
Considering that phimosis is easily treated, circumcision actually increases the risk of penile cancer.
Can this result be correct? Possibly; keep in mind that the foreskin has
immunological capabilities, and so is able to fight disease. [18] So
the endless discussions and studies by Schoen and others are meaningless
distractions from the final result. Circumcision is then an invasive
surgical alternative to simple hygiene. Despite the obvious conclusion,
the AAP still makes the following statement about circumcision and
penile cancer reduction:
It is difficult to establish how many male circumcisions it would
take to prevent a case of penile cancer, and at what cost economically
and physically. One study with good evidence estimates that based on
having to do 909 circumcisions to prevent 1 penile cancer event, 2
complications would be expected for every penile cancer event avoided.
However, another study with fair evidence estimates that more than
322 000 newborn circumcisions are required to prevent 1 penile cancer
event per year. This would translate into 644 complications per cancer
event, by using the most favorable rate of complications, including rare
but significant complications. The clinical value of the modest risk
reduction from circumcision for a rare cancer is difficult to measure
against the potential for complications from the procedure. In addition,
these findings are likely to decrease with increasing rates of HPV
vaccination in the United States. [17]
The American Cancer Society has been an outspoken opponent of infant
circumcision in the prevention of both penile and cervical cancers,
claiming that circumcision is not a “valid or effective measure to
prevent such cancers.” [19] The ACS believes that the incidence of
penile and cervical cancers can be significantly reduced without cutting
off body parts. Not smoking and good hygiene are big factors in
prevention, but the ACS also believes that vaccines against HPV should
also be used. [20]
Two types of HPV (types 16 and 18) are responsible for 70% of all
cervical cancers and nearly half of all vaginal, vulvar, and penile
cancers. [21] How effective are the HPV vaccines? “The trials
demonstrated nearly 100% vaccine efficacy in preventing cervical
precancers, vulvar and vaginal precancers, and genital warts in women
caused by the vaccine types, as well as 90% vaccine efficacy in
preventing genital warts and 75% vaccine efficacy in preventing anal
precancers in men.” [22] The same benefits should be observed for penile
cancer, but because penile cancers are not seen until old age, the
results are not yet fully known. Circumcision is 19th century medicine;
today we have better solutions than cutting our genitals.
----------------------------------------------------------------------
- Til að forðast gagnrýni - gerðu ekkert, segðu ekkert, vertu ekkert -