To circumcise or not to circumcise?

Reply Thu 6 Sep, 2012 06:50 pm
A Hypothetical Anti-Circ World.

Using the well established 1:600 lifetime risk for penile cancer in the uncircumcised U.S. population. Assuming 100% were Uncircumcised: 45,346,137 males born within 20 years prior to 2010 (U.S. Census). 45,345,137/600=

*75,576.89 (Diagnosed Cases in Generation)
*18,894.22 (Deaths in Generation, assuming 25% mortality)

Incidence of Penile Caner if 100% of Men Were Uncircumcised:
2010 U.S. Census 151,781,326 (males)
I don’t have the 2010 American Cancer Society numbers for IPC so let’s average 2007 and 2012 projections together: 1,280 + 1,570 = 2,850 / 2 = 1,425.
151,781,326-73% (circumcised males- CDC) = 40,980,958 (uncircumcised)/1,425 (est. 2010 diagnosed) = 28,758
= 1 : 28,758 (single year risk per uncircumcised male, penile cancer)

*5,277.8 (Diagnosed Cases, 2010)
*1,319.5 (Deaths assuming 25% mortality, 2010)

Yes, I understand the HPV vaccine is going to end all cancer everywhere. What about the host of other benefits and the mounting (if yet incomplete) AIDS research? How do all of these extrapolate? Don't look at what the total incidence are but rather what they WOULD be without circumcision. My philosophy has always been to give people the best information available and trust them to balance their conscience with their personal circumstance to reach a moral/ethical decision that is right for them.

There hasn't been enough research into mass paranoia or whatever this phenomena is. All of the medical evidence that is on the anti-circ side is fabricated or twisted beyond recognition.

The evidence for their side of the issue is all recent and funded by anti-circ groups or by psuedo-professionals who stated their views before their research and to no one's surprise came back with evidence that proves their claim. The evidence in favor of circumcision goes back for decades and has been accepted and held up time and time again to the scrutiny of peer review. Your side can cherry pick a few instances of poorly designed studies but they are a drop in the bucket.

Most anticircs have posted comments stating there is no medical rationale for circumcision. They are wrong. Period. Ive read them. No one is saying there isnt some level of risk. What the experts on this ARE saying is that the benefits outweigh them. There IS a value to circumcision. THEY blindly reject all value. Pot calling the kettle black. No value is not the same thing as risks outweigh the benefits. Why do you think so many people STILL circumcise?

The ones that are against it are never medical professionsionals. Circumcision prevents penile cancer, syphilis, balanoposthitis and phimosis. To keep an uncut penis clean you have to wash EVERY DAY. I guess that rules out camping or joining the army if you're uncircumcised

The foreskin evolved because our ancestors ran through tall grass and swung from trees nude, a little extra protection probably wasn't a bad thing. Your ancestors were elderly at 30 and typically didn't live long enough to develop many of the maladies we suffer today. The foreskin has been redundant and a liability since the advent of the loom. Unless you're recommending we all start walking around nude to diminish the incidents of infection and inflammatory diseases then circumcision is a reasonable course of action. The ten countries that have the lowest rate of HIV are all countries that practice circumcision.

I love the "proper hygiene" "safe sex" argument. If humans have proven one thing through out our history it's that we aren't very responsible as a whole. Besides, even the cleanest person cannot avoid any bacterial, viral or fungal exposure. Just do the experiment of showering using NO deodorant/antiperspirant and then do some moderate but steady house work and see how long it takes before you can smell steamed hot dogs, that odor is the byproduct of bacteria. Any warm, moist, dark place will encourage pathogens to thrive. Moving beyond that is the HPV (the virus correlated with this and other cancers). An uncircumcised penis is highly susceptible to HPV because the soft mucosal tissues of the foreskin and glans are susceptible to micro-abrasions. It easily infects the soft moist skin of the glans and underside of the foreskin. In other words you could shower before and after sex and still be infected. Poor hygiene elevates the risk, not creates it. If circumcision were outlawed there would be 5,059 cases diagnosed with 1264.8 deaths and aproximately the same number of penile amputations each year. 25296. Every generation would be diagnosed with 101,180 cases and 25,296 of them would die.

I'm also tired of hearing people say the chance of penile cancer is only 1:100,000. That is not even remotely accurate.

To illustrate the point:
1:100,000 is the chance of all males in the population if they are lumped together for one year regardless of whether they are 18 or 75 (median age of onset is 60). Assuming a man lives an average life expectancy of 75 years the chances of developing penile cancer are 75:100,000 in his life time.

Lets say uncircumcised men make up 30% of the population. Since invasive penile cancer is almost exclusive to uncircumcised men we can say approximately 75:30,000=1:400. Obviously there are a lot more variables at play but it brings us close enough to the actual number to demonstrate the point.

The actual number is 1:600 in the USA.

The "Intact" crowd has also been pointing to Denmark for having a lower rate than the U.S. and alleging this is proof circumcision is not to credit. Denmark has roughly 25% of it's males circumcised. As you've seen it's is only appropriate to compare the uncircumcised populations of the two countries. Denmark's rate is 1:900 as opposed to the US's 1:600 is close enough to be explained by environmental, genetic and cultural differences. Their circumcised males also rarely develop invasive penile cancer.

Statistics on the American Cancer Society web page indicate 1,280 new cases of penile cancer in 2007, with 290 deaths [American, 2007b]. 25-30% mortality

People circumcised as men get invasive penile cancer, very few people circumcised as children get it. Those circumcised as infants never get it. We're not talking about cancerous freckles here, go ahead and google some some pictures of invasive penile cancer so you know what we're talking about. If you want to grasp on to those two cases every three years and say that represents anything worth discussing then you're desperate.

It isn't even possible that everyone in the world for the past 80-100 years is wrong except the few small scale highly biased studies that you guys have cherry picked.

If you’re only going to dismiss all professional organizations supporting circumcision then I get to dismiss ACS. You've seen my post explaining the math behind their 1:100,000. So it should be apparent they didn't put a lot of thought into their release.
If you object morally and ethically then state that all you want, make all of those types of arguments you want. Circumcision is necassry.

I gave you anti-circ's a substantial list of facts. To continue to insist circumcised men represent any kind of risk is the definition of irrational.
The CDC has adamantly refuted the 100 deaths a year from circumcision in the United States. The study cited for that number was a highly biased review of metadata by an individual active with "Intact America" prior to their findings. His method for obtaining that method is preposterous.

This gentleman explains the methodology and flaws better than I can.

Edit [Moderator]: Link removed

I for one am more than happy and am very pleased with the fact that my parents took the advise of Medical Science and no emotion or fear. My parents are in line with the World Leading Scientist of the United Nations

Do you disagree with their Researched Science ? Program managers, and health advocates from the following institutions have provided review of materials written for the Clearinghouse on Male Circumcision for HIV Prevention:

Harvard University School of Public Health

Jhpiego (Johns Hopkins Program for International Education in Gynecology and Obstetrics)

London School of Hygiene and Tropical Medicine

University of Illinois at Chicago School of Public Health


So I ask you again, do you deny The World Health Organization and The Joint United Nations Programme on HIV and AIDS, or UNAIDS ?

You anti-circs may disagree and deny the researched and proved facts of the medical science behind it, but the Fact is that the World Health Organization which is comprised of Medical Doctors, Public Health Specialists, Scientists and Epidemiologists from countries around the entire Globe. The WHO in concert with the Joint United Nations Programme on HIV/AIDS (UNAIDS) and Family Health International (FHI) They are performing this procedure every day on "Males of All Ages" to help fight World Wide Disease.
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Reply Thu 6 Sep, 2012 06:58 pm
Now this study has come out:
Edit [Moderator]: Link removed

"Early termination of clinical trials may overestimate treatment effects"
All three of the African trials on which the circumcision claims are based were terminated early.

"...especially when the decision to terminate the trial is based on the finding of an apparently beneficial treatment effect,"
That is why all three trials were terminated.

"Bias may arise because large random fluctuations of the estimated treatment effect can occur, particularly early in the progress of a trial. When investigators stop a trial based on an apparently beneficial treatment effect, their results may therefore provide misleading estimates of the benefit."

"For truncated R[andomised ]C[ontrolled ]T[rial]s having fewer than 500 events, there were large differences in treatment effect size between truncated and nontruncated RCTs"
The three circumcision-HIV RCTs put together had a total of only 196 events.

Maybe if the UN HIV sub-committee considering circumcision had had access to this study (and other material critical of the studies) they might not have been so easily railroaded by a handful of circumcision enthusiasts.
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