EDITOR,--Paul M Fleiss and Frederick Hodges claim that epidemiological studies long ago disproved the "myth" that neonatal circumcision has a protective effect against penile cancer[1]. They quote only one such study, that of Maden et al[2], and, curiously, omit its main conclusion--that "absence of neonatal circumcision and potential resulting complications are associated with penile cancer." The odds ratio for those never circumcised compared with those who had undergone neonatal circumcision was 3.2 (95% confidence interval 1.8 to 5.7), while for those circumcised later it was 3.0 (1.4 to 6.6).
I know of no analytical epidemiological study whose results support Fleiss and Hodges's claim.
References
- Fleiss PM, Hodges F. Neonatal circumcision does not protect against penile cancer. BMJ 1996; 312: 779-80. (23 March.)
- Maden C, Sherman KJ, Beckmann AM, Hislop TG, Ten CZ, Ashley RC, et al. History of circumcision, medical conditions and sexual activity and risk of penile cancer. JNCI 1993;85:19-24.