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Medical Forum / General / Alternative / September 2005

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Penile Cancer

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Briar Rabbit - 24 Sep 2005 08:31 GMT
They found that "significant risk factors for invasive penile cancer:
lack of circumcision during childhood, phimosis and cigarette smoking."

More:

"Men not circumcised during childhood were at increased risk of
invasive (penile cancer) (OR = 2.3, 95% CI 1.3-4.1)."

"Among men not circumcised in childhood, phimosis was strongly
associated with development of invasive penile cancer (OR = 11.4, 95%
CI 5.0-25.9)."

And from the main body of the study itself:

"We posit that men who have never been circumcised may be at
higher risk of HPV acquisition and persistence even though they
appear to have engaged in lower-risk sexual activity than men
who are circumcised in childhood."

==========================
Penile cancer: importance of circumcision, human papillomavirus and
smoking in in situ and invasive disease.

Daling JR, Madeleine MM, Johnson LG, Schwartz SM, Shera KA, Wurscher
MA, Carter JJ, Porter PL, Galloway DA, McDougall JK, Krieger JN.

Program in Epidemiology, Division of Public Health Sciences, Fred
Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
jdaling@fhcrc.org

Few population-based case-control studies have assessed etiologic
factors for penile cancer. Past infection with high-risk human
papillomavirus (HPV) is a known risk factor for penile cancer;
however, few previous studies have related the HPV DNA status of the
tumor to potential demographic and behavioral risk factors for the
disease or evaluated whether in situ and invasive penile cancer share
risk factors. Little information is available on the role and timing
of circumcision in the etiology of penile cancer. We conducted a
population-based case-control study in western Washington state that
included 137 men diagnosed with in situ (n = 75) or invasive (n = 62)
penile cancer between January 1, 1979, and December 31, 1998, and 671
control men identified through random digit dialing. Cases and
controls were interviewed in person and provided peripheral blood
samples. Case and control blood samples were tested for antibodies to
HPV16 and HSV-2, and tumor specimens from cases were tested for HPV
DNA. Men not circumcised during childhood were at increased risk of
invasive (OR = 2.3, 95% CI 1.3-4.1) but not in situ (OR = 1.1, 95% CI
0.6-1.8) penile cancer. Approximately 35% of men with penile cancer
who had not been circumcised in childhood reported a history of
phimosis compared to 7.6% of controls (OR = 7.4, 95% CI 3.7-15.0).
Penile conditions such as tear, rash and injury were associated with
increased risk of disease. Among men not circumcised in childhood,
phimosis was strongly associated with development of invasive penile
cancer (OR = 11.4, 95% CI 5.0-25.9). When we restricted our analysis
to men who did not have phimosis, the risk of invasive penile cancer
associated with not having been circumcised in childhood was not
elevated (OR = 0.5, 95% CI 0.1-2.5). Cigarette smoking was associated
with a 4.5-fold risk (95% CI 2.0-10.1) of invasive penile cancer. HPV
DNA was detected in 79.8% of tumor specimens, and 69.1% of tumors were
HPV16-positive. The proportion of HPV DNA-positive tumors did not vary
by any risk factors evaluated. Many risk factors were common for both
in situ and invasive disease. However, 3 factors that did not increase
the risk for in situ cancer proved significant risk factors for
invasive penile cancer: lack of circumcision during childhood,
phimosis and cigarette smoking. The high percentage of HPV DNA-
positive tumors in our study is consistent with a strong association
between HPV infection and the development of penile cancer regardless
of circumcision status. Circumcision in early childhood may help
prevent penile cancer by eliminating phimosis, a significant risk
factor for the disease. (c) 2005 Wiley-Liss, Inc.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15825185&query_hl=3
junk01@intactivist.org - 24 Sep 2005 14:24 GMT
> They found that "significant risk factors for invasive penile cancer:
> lack of circumcision during childhood, phimosis and cigarette smoking."
[quoted text clipped - 69 lines]
> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
> cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15825185&query_hl=3

2. smt_AC   Sep 24, 5:44 am     show options

Newsgroups: alt.circumcision
From: "smt_AC" <jun...@intactivist.org> - Find messages by this author

Date: 24 Sep 2005 05:44:42 -0700
Local: Sat, Sep 24 2005 5:44 am
Subject: Re: Penile cancer: importance of circumcision ...
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- Show quoted text -

> They found that "significant risk factors for invasive penile cancer:
> lack of circumcision during childhood, phimosis and cigarette smoking."

> More:

> "Men not circumcised during childhood were at increased risk of
> invasive (penile cancer) (OR = 2.3, 95% CI 1.3-4.1)."

> "Among men not circumcised in childhood, phimosis was strongly
> associated with development of invasive penile cancer (OR = 11.4, 95%
> CI 5.0-25.9)."

> And from the main body of the study itself:

> "We posit that men who have never been circumcised may be at
> higher risk of HPV acquisition and persistence even though they
> appear to have engaged in lower-risk sexual activity than men
> who are circumcised in childhood."

> ==========================
> Penile cancer: importance of circumcision, human papillomavirus and
> smoking in in situ and invasive disease.

> Daling JR, Madeleine MM, Johnson LG, Schwartz SM, Shera KA, Wurscher
> MA, Carter JJ, Porter PL, Galloway DA, McDougall JK, Krieger JN.

> Program in Epidemiology, Division of Public Health Sciences, Fred
> Hutchinson Cancer Research Center, Seattle, WA 98109-1024, USA.
> jdal...@fhcrc.org

> Few population-based case-control studies have assessed etiologic
> factors for penile cancer. Past infection with high-risk human
[quoted text clipped - 36 lines]
> prevent penile cancer by eliminating phimosis, a significant risk
> factor for the disease. (c) 2005 Wiley-Liss, Inc.

> http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?
> cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15825185&query_hl=3

Wow, that's great news! It looks like preventing phimosis may reduce
any risk of penile cancer to the same rates as circumcised men.

"When we restricted our analysis to men who did not have phimosis, the
risk of invasive penile cancer associated with not having been
circumcised in childhood was not elevated (OR = 0.5, 95% CI 0.1-2.5)."

Foreskins don't cause cancer, phimosis does. Phimosis is easily treated

and often preventable. Obviously, they are talking about acquired
phimosis, as all men have congenital phimosis at birth, so that must
not be a factor. The cause of acquired phimosis is poor hygiene,
repetitive forceful retraction by parents or doctors, and recurring
infection (often a result of the previously listed items). So, first,
educate doctors and parents about proper care and hygiene, then have
true acquired phimosis diagnosed and treated early on. The option of
circumcision could be considered for those rare cases with recurring
infections. Of course, not smoking is also important to prevent penile
cancer, as is not being exposed to HPV.

Thanks for that great news. This is why evidence based research is so
important for developing modern medical policies, to not only
treat/prevent disease, but also to allow a person to experience life,
and their whole body, to the fullest extent.
Briar Rabbit - 25 Sep 2005 03:31 GMT
> Foreskins don't cause cancer, phimosis does.

Dear heaven you are desperate.

Phimosis is the result of a dysfunctional foreskin. Circumcised men do
not have foreskins and therefore do not have this risk. Quite simple
really if you have an open mind.
 
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