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Neonatal male circumcision and cancer
There has been recent discussion in the Australian media about neonatal male circumcision, including suggestions that circumcision can reduce the risk of cancer.
While there is some evidence that neonatal circumcision can help protect against penile cancer (cancer of the penis), this is not sufficient to recommend circumcision to prevent the disease. Cancer Council Australia supports the evidence-based position of the Royal Australian College of Physicians, which states:
“In developed countries penile cancer is a relatively rare disease, with an incidence of approximately 1 in 100,000. The absence of randomised controlled trial evidence, combined with the rarity of penile cancer, suggests that circumcision is not justified for the sole purpose of protecting against penile cancer” (1).
While a recent study suggests that circumcision may reduce the risk of prostate cancer, more research is needed before there is sufficient evidence to recommend population-level circumcision to help reduce prostate cancer incidence. The main risk factor for prostate cancer is ageing, with incidence of the disease increasing significantly as men age.
There is evidence to consider wide-scale male circumcision in countries with insufficient resources to help prevent HPV infections and HPV-related cancers. Australia, however, has a population-based HPV immunisation program. Although vaccination is confined to females at this time, the consequent reduction in HPV infection is also expected to result in substantial drops in HPV infection among heterosexual males.
In November 2011, the Pharmaceutical Benefits Advisory Committee recommended that boys be added to the National HPV Vaccination Program (2). The recommendation specified ongoing administration to 12-13 year old males with a catch-up to 14-15 years, however pricing and supply agreements, critical to implementation, have yet to be announced (as at June 2012). Male vaccination has the potential to further reduce HPV transmission among both heterosexual males and men who have sex with men, thus even further reducing the need to consider circumcision as a cancer control measure.
Taking into account these issues, the relatively lower burden of potentially preventable disease in Australia, and the complex cultural, ethical and legal issues surrounding the practice of circumcision, Cancer Council Australia does not recommend circumcision as a routine cancer-preventive procedure at this time.
(1) Royal Australasian College of Physicians RACP Policy Statement On Circumcision.
(2) Pharmaceutical Benefits Advisory Committee (Australia): November 2011.
This page was last updated on: Monday, August 20, 2012