Archives Of Dermatology October 1997
An Ulcerative Lesion of the penis. Diagnosis: Squamous cell carcinoma of the penis.
Keneth A Arndt, MD
Edgar J.Schoen, MD, The Relationship Between Circumcision And Cancer Of The Penis. A Journal Of The American Cancer Society, September/October 1991; Vol.41, No.5; 306-309
"Undocumented policy statement, heated arguments, media interest, and trendy lay anticircumcsion groups have generated much heat and have confused issues that seemed clear prior to 1970."
"In a classic 1935 report and discussion Dean analyzed 120 cases of penile cancer from Memorial hospital in New York City. None were Jews, although more than one third of the cancer patients at the hospital were Jewish. Dean noted that circumcision later in life did not offer the complete protection against penile cancer that newborn circumcision did. In Dean's series, the average age of diagnosis of cancer of the penis was 50, with 22 percent before age 40.
"In the subsequent 56 years, published studies from other US medical centers have confirmed Dean's findings. There were reports of 139 penile cancers from Illinois in 1946; 100 from Rosewell Park, New York, in 1972; 156 cases from Michigan in 1973; and 77 from Cleveland in 1986. Of the resulting 592 penile cancer cases from five institutions around the US, not one of the men had been circumcised in infancy despite the fact that by the mid 1970's most males in the US had been circumcised as newborns."
Dahn R, SelzerHL, Lapides J. Carcinoma of the penis and the anti-circumcision crusade. J Urol 1973; 110: 79-80
"During 25 years at the University of Michigan medical Center, we have been impressed by the mortality associated with carcinoma of the penis and the relationship of the prepuce to the disease." A high percentage of patients do not seek medical treatment until the disease is in an incurable state. "Our evidence leads us to believe that circumcision-- at any age will virtually prevent onset of squamous cell carcinoma of the penis if the neoplasm is not present at the time of circumcision and the prepuce is completely removed."
Cambells Urology, Vol2, 5th Ed, 1986, p. 1590
"Any argument against circumcision must take into account that the fact that penile carcinoma represents the only neoplasm for which there exists a predictable and simple means of prophylaxis that spares the organ at risk"
Urology Times, March 1987, p.11.
Dr. Terrence Malloy noting the effectiveness of treating preinvasive carcinoma of the penis with a laser states further, "It avoids the disabling sexual and psychological trauma associated with partial penectomy." He concludes that although penile cancer has usually been restricted to the elderly in the united States, "in the future urologists will be seeing more penile cancer due to the reduction in routine circumcision."
Graham JH, Helwig EG. Erythroplasia of Queyrat. Cancer 1973; 32:1396-1414.
Observations from 100 men with Erythroplasia of Queyrat (EQ is a precancerous condition) indicate that the disease is a distinct entity of men only. Some observers believe that EQ is Bowens disease of the penile mucosa with carcinomatous potential (10 patients had invasive squamous cell carcinoma (SCC). The lesions involved mucosal sites on the distal part of the penis including the glans, urethral meatus, frenulum, corona, sulcus and prepuce.
A common occurance was difficulty in retracting the foreskin over the glans. The one consistent genital feature was that 84 patients had not been circumcised before the onset of their penile lesions. The age at time of circumcision was 9 years, 18 years, and adulthood in three others. Status of circumcision in 13 patients was not known. The definate etiology of EQ remains unknown, but factors in cancer developement may be local carcinogens in uncircumcised men. "There is only one certain aspect regarding the cause of EQ and that is the disease is similar to SCC of the penis in occuring in non-Jewish uncircumcised peoples of the world."
Oldbaing J, Mikulowski P. Malignant melanoma of the penis and male urethra. Cancer 1987;59:581-587.
The authors citing date from the Swedish Cancer Registry reported 1210 cases of carcinoma of the penis from 1958 to 1980. [Thus the average rate in Sweden is 55 cases/year versus the United States average of 748 cases/year. Since the Swedish population (Information Please Almanac, 1985) is 8.330 million versus a U.S.A. of 233.70 million, the U.S.A. is 28.05 times greater in population. Therefore, a rate of 55x28.05=1543 penile cancer cases might be expected in the United States whereas onlt 748 were seen. this 2 times graeter rate of penile cancer in Sweden where newborn circumcision is not practiced undercuts statement by anti-circumcision activists who continually use the Nordic societies as samples of good hygiene thereby able to prevent cancer of the penis equally as well without circumcision.-AJF, Circumcision: A Parent's Decision for Life]
Hellberg D, Valentin J, Eklund T,Nilsson S. Penile Cancer: Is there an epidemiological role for smoking and sexual behavior? Brit Med J 1987; 295;1306-1308.
"In Sweden an average of 50 men a year are diagnosed as having cancer of the penis giving an incidence of 1.4 per 100,000. All cases of cancer are registered at the National Cancer registry which in 1959-80 registered 1064 new cases."
Leiter E, Lefkovits A. Circumcision and penile carcinoma. NY St J Med, August 1975; 1520-1522. "Circumcision at birth virtually prevents the later development of penile cancer."
Boczko S, Freed S. Penile carcinoma in circumcised males. NY St J Med, November 1979; 1903-1904.
Incidence is so rare that only nine cases have been reported in the world literature to date.
Hosze K, Mcurdy S. Circumcision and the risk of cancer of the penis. Am J Dis Child 1980; 134;484-486.
"The lifetime risk for cancer of the penis in uncircumcised males is one in 600."