Dr. Khalid Aziz
Member, Board of Directors, Canadian Paediatric Society

Dear Dr. Aziz:

I'm writing in regard to the interview in which you participated recently on CBC Newsworld ("Health Matters," May 31st). I watched with great interest and would like to raise some issues.

In response to the interviewer's question, "What are the proven benefits of circumcision?" you said that newborn circumcision is likely to prevent urinary tract infections in young boys and may prevent penile cancer in later life.

The idea that circumcision prevents penile cancer was first put forward nearly 70 years ago in Lancet by Dr. Abraham Wolbarst.[1] Dr. Wolbarst was a prominent and influential member of the American Society of Sanitary and Moral Prophylaxis, an organization dedicated to stamping out sexual immorality. Besides the article on penile cancer, his legacy includes an opinion piece calling for sterilization of adult masturbators,[2] and a study purporting to show that circumcision prevents epilepsy.[3]

The current position of the American Cancer Society (ACS), a recognized authority in the field, is that “circumcision is not of value in preventing cancer of the penis.[4] Moreover, ACS statistics show that cancer of the penis is among the rarest of all malignancies, rarer even than male breast cancer. The risk of suffering life-threatening complications from circumcision exceeds by far the risk of developing penile cancer.

Four times as many people in the United States die each year from cancer of the vulva as from cancer of the penis. Consequently if the goal is to prevent deaths from cancer, then excision of the external female genitals would be a much more effective strategy than male circumcision.

When asked what risks are involved in performing newborn circumcision, you mentioned surgical complications and pain, but did not touch on the ethical and legal issues raised when a non-consenting minor is forced to undergo surgery that is not medically required.[5,6] Nor did you refer to recent Canadian research demonstrating that circumcision permanently removes specialized sexual tissue.[7]

I would appreciate it if you could explain why you reinforced the idea that newborn circumcision has proven medical benefits, but failed to mention that the operation may violate basic principles of medical ethics and remove a sexually significant part of the penis.

Thank you for considering the issues I have raised.

References:

Sincerely,
 
[signed]
 
D ennis H arrison

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