WORLD HEALTH ORGANIZATION            ORGANISATION MONDIALE DE LA SANTE

              INTERNATIONAL AGENCY FOR RESEARCH ON CANCER
          150, Cours Albert Thomas 69372 Lyon Cédex 08, France

In reply please refer to: FI/92/3                           1 May 1997


Dear Dr Lannon,

   I am writing following the request of Mr DeSeabra in relation to his
concerns about the recommendations to be made by the American Academy of
Pediatrics concerning circumcision and the prevention of cervical and
penile cancers.

   Considering that:

1. there is no clear and solid epidemiological evidence linking circumcision
   to a reduced risk of cervical cancer and that the link of circumcision to
   a reduced risk of penile cancer is weak; and that

2. on the other hand, it is now accepted that certain types of human
   papillomavirus (HPV) play a central role in the causation of cancer of the
   cervix and of the penis,

I believe that efforts on the prevention of these cancers should be directed
at the prevention of HPV infection and not at the promotion of routine
circumcision.

                               Yours sincerely,

                                  (signed)

                               Dr Nubia Muñoz
                               Chief, Unit of Field and Intervention Studies