Prostate Cancer? Yet Another Bogus Justification for Circumcision

As more and more Americans realize they’ve been sold a bill of goods about circumcision, and as fewer parents are willing to allow their sons to be tied down and mutilated for a fee, physicians and others with a financial or psychological interest struggle to find new reasons for promoting the Great American Rip-Off .

This week’s example comes via an article published in the journal Cancer, which describes a “statistical sampling” study leading to the conclusion that circumcision may lead to lower prostate cancer rates. “Circumcision,” the study claims, “can hinder infection and inflammation that may lead to this malignancy.”

I could say a lot about this “study,” but in the interest of brevity and timeliness, I will limit myself to the following:

First, the authors relied on self-reporting for circumcision status, history of sexually transmitted diseases (STDs), and age at first intercourse. Self-reports about disease history and sexual behavior are inherently problematic. Self-reports about circumcision status have been shown repeatedly to have a high error rate of +/- 5 percent, or enough to nullify any statistical significance claimed in the study.

Second, the body of medical literature does not support the claim for a lower rate of STDs in circumcised men—either in the United States or abroad. In response to the new study, Medscape News (login required, free registration) interviewed independent physicians regarding the report in Cancer. Siobhan Sutcliffe, PhD, Assistant Professor of Public Health Sciences at Washington University School of Medicine, noted that results from a self-reporting, case-control study are much less reliable than those from a clinical trial. “It is too early to make recommendations about circumcision for prostate cancer prevention,” she said. “More and different types of studies need to be done before a preventive recommendation can be put forward.”  Anthony Y. Smith, MD, Professor and Chief of Urology in the Department of Surgery at the University of New Mexico Cancer Center, also noted that it is “extremely difficult to evaluate the effect of circumcision on a wider geographic scale outside of a controlled clinical trial.” As he mentions, the prevalence of prostate cancer and sexually transmitted infections is similar in the United States, where circumcision is common, to that in Western Europe, where it is not.

Finally, the authors themselves admit that the exact mechanism through which circumcision might prevent prostate cancer remains unknown. Thus, their hypothesis that the foreskin is the cancer-causing culprit requires us to accept that “germs flourishing in the moist environment under the foreskin” somehow make their way into the prostate and cause cancer. Without actual, clinical proof of this, the giddiness regarding one more justification for circumcision is inappropriate—to say the least.

The real lesson here is that current science and news publications set the bar far higher for studies showing the risks and harms of circumcision than they do for lame, unfounded claims touting the “benefits” of removing healthy body parts from babies who are many years away from being sexually active. (And, by the way, whatever happened to condoms, which protect both males and females?) For the promoters of infant circumcision, it appears to be a fact-free, evidence-free environment.

Current estimates of boys leaving the hospital intact range from 33 to 54.5 percent, up from a rate of just 10 percent in the 1960s. It is disheartening that the medical establishment promotes the bogus science, ignores the ethics, and continues to scrape the bottom of the barrel for reasons to keep cutting babies. However, parents are seeing beyond the smoke and mirrors and are getting wise to the Great American Rip-Off.

Georganne Chapin