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ELECTRONIC ARTICLE: Edgar J. Schoen, Michael Oehrli, and Geoffrey Machin The Highly Protective Effect of Newborn Circumcision Against Invasive Penile Cancer Pediatrics 2000; 105: e36 [Abstract] [Full text] [PDF]

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penile cancer and routine newborn circumcision uncommon in Finland

Esko Lansimies   (6 March 2000)

Response of Dr Esko Lansimies to Penile Carcinoma

Edgar J Schoen   (22 March 2000)

Putting penile cancer in perspective

Dennis Harrison   (6 July 2000)

penile cancer and routine newborn circumcision uncommon in Finland 6 March 2000
Esko Lansimies, professor, chief physician Kuopio University and University Hospital Send letter to journal: Re: penile cancer and routine newborn circumcision uncommon in Finland esko.lansimies{at}kuh.fi Esko Lansimies	In Finland male newborns are extremely rarely circumcised due to non- medical reasons. Penile cancer incidence in Finland is extremely rare less than 0.5 per 100 000 person-years. Age-adjusted mortality in penile cancer is one per million person years. According to Finnish experienca, parents decision not to circumcise their male children protects the men from penile cancer. Esko Länsimies, professor University and University Hospital of Kuopio, Finland
Response of Dr Esko Lansimies to Penile Carcinoma 22 March 2000
Edgar J Schoen, Pediatrician Kaiser Permanente Send letter to journal: Re: Response of Dr Esko Lansimies to Penile Carcinoma Edgar.Schoen{at}kp.org Edgar J Schoen	I am puzzled by the statement of Dr Lansimies that the decision not to circumcise actually protects against penile cancer. Although it is true that small, developed countries like Finland and the Scandinavian nations have a low incidence of penile cancer, these risks are still 5-10 times as high as in developed countries in which essentially all baby boys are circumcised such as Israel (incidence 0.1/100,000). Uncircumcised men in underdeveloped countries with poor genital hygiene have penile cancer rates up to 100 times as high as in Israel. Further, Dr Lansimies ignores the other medical benefits of newborn circumcision including the prevention of urinary tract infections in infants (about 10 times the risk in uncircumcised vs circumcised babies), and protection against heterosexually transmitted HIV infection (about 2-4 times lower risk in circumcised men as found in over 30 epidemiological studies). Prevention of balanoposthitis and phimosis and improved genital hygiene are other benefits. We have received recent data from Dr Lansimies' country, Finland, showing that about 2000 Finnish males annually receive post-neonatal circumcision for medical reasons (presumably phimosis and recurrent balanoposthitis). Since there about 30,000 infant boys born annually in Finland, this means that about 6% of uncircumcised newborn boys will have to be circumcised later in life, when the procedure is more difficult and expensive.
Putting penile cancer in perspective 6 July 2000
Dennis Harrison, Writer Send letter to journal: Re: Putting penile cancer in perspective dch{at}direct.ca Dennis Harrison	The notion that circumcision protects against penile cancer was first propounded in the medical literature by Dr. Abraham L. Wolbarst.1 A member of the American Society of Sanitary and Moral Prophylaxis, Dr. Wolbarst also believed that tight foreskins cause epilepsy and convulsions.2 The incidence of penile cancer in Denmark,3 where circumcision is almost unknown, is lower than it is in the United States,4 where most men are circumcised.   1 Wolbarst AL. Circumcision and penile cancer. Lancet 1932;1:150-3. 2 Wolbarst AL. Does circumcision in infancy protect against disease? Virginia Medical monthly 1934;60:723-8. 3 Frisch S et al. Falling incidence of penis cancer in an uncircumcised population. BMJ 1995;311:1471. 4 Wingo PA, Tong T, Bolden S. Cancer statistics, 1995. CA Cancer J Clin 1995;45:8-30.