Canadian Family Physician, Volume 49: Page 1591, December 2003.
Dr Rivet1 has failed to review criticism of the article2 by Castellsagué et al in the New England Journal of Medicine. The article has been criticized for its poor methodology,3 because circumcision removes specific erogenous tissue4-6 and because male and female partners have different types of human papillomavirus (HPV).7
Castellsagué and colleagues admit to being “puzzled” by these findings. In addition, they emphasize that they did not recommend circumcision.8 These comments place Castellsagué and colleagues’ findings regarding circumcision’s protective effects against cervical cancer in the dubious category.
A vaccine for HPV has been tested and found to be effective.9 It is probable that, by the time infants born today reach maturity, a vaccine will be available to prevent cervical cancer.
In view of the above, neonatal circumcision cannot be recommended to prevent cervical cancer. Human papillomavirus causes cervical cancer; the foreskin does not. Safer sex, not circumcision, prevents the spread of HPV.
The recent cautionary statements by three provincial colleges of physicians and surgeons regarding non-therapeutic circumcision of male children should be of greater concern to family physicians.10-12
Executive Secretary, Doctors Opposing Circumcision
The original of this document is located at: http://www.cfpc.ca/cfp/2003/Dec/vol49-dec-letters-4.asp.
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