[CIRP Note: This letter was written in 1996. At that time, American Academy of Pediatrics (AAP) was promoting a circumcision policy statement that was published in 1989. That policy, which was developed by a task force chaired by Edgar J. Schoen, M.D., inappropriately claimed that lack of circumcision was associated with penile cancer. Partially as a result of this letter, the AAP formed a new task force, chaired by Carol Marie Lannon, M.D., that later developed a new circumcision policy statement, which more appropriately described the risk factors for penile cancer as phimosis, use of tobacco, and the presence of human papilloma virus (HPV).]
[CIRP note: The American Cancer Society has updated their website to include a commentary about this letter. The content of the ACS web page is substantively in agreement with the content of the letter of Heath and Shingleton. The ACS does not have an official policy on circumcision. See Detailed Guide: Penile Cancer.]
AMERICAN CANCER SOCIETY NATIONAL HOME OFFICE February 16, 1996 Dr. Peter Rappo Committee on Practice & Ambulatory Medicine American Academy of Pediatrics 141 Northwest Point Boulevard P. O. Box 927 Elk Grove Village, IL 60009-0927 Dear Dr. Rappo: As representatives of the American Cancer Society, we would like to discourage the American Academy of Pediatrics from promoting routine circumcision as preventative measure for penile or cervical cancer. The American Cancer Society does not consider routine circumcision to be a valid or effective measure to prevent such cancers. Research suggesting a pattern in the circumcision status of partners of women with cervical cancer is methodologically flawed, outdated and has not been taken seriously in the medical community for decades. Likewise, research claiming a relationship between circumcision and penile cancer is inconclusive. Penile cancer is an extremely rare condition, effecting one in 200,000 men in the United States. Penile cancer rates in countries which do not practice circumcision are lower than those found in the United States. Fatalities caused by circumcision accidents may approximate the mortality rate from penile cancer. Portraying routine circumcision as an effective means of prevention distracts the public from the task of avoiding the behaviors proven to contribute to penile and cervical cancer: especially cigarette smoking and unprotected sexual relations with multiple partners. Perpetuating the mistaken belief that circumcision prevents cancer is inappropriate. Sincerely, Hugh Shingleton, M.D. Clark W. Heath, Jr., M.D. National Vice President Vice President Detection & Treatment Epidemiology & Surveillance Research 1599 CLIFTON ROAD, N.E., ATLANTA GEORGIA 30329 404-320-3333
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