Talk:Carcinoma of the penis

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[edit] AMA and RACP on circumcision and penile cancer

The American Medical Association and the Royal Australasian College of Physicians say the use of infant circumcision to prevent penile cancer in adult men is not justified.

  • "Nevertheless, because this disease is rare and occurs later in life, the use of circumcision as a preventive practice is not justified." -- American Medical Association. Neonatal Circumcision. Dec 1999.
  • "Penile cancer is a rare disease with an incidence of around 1 per 100,000 in developed countries. Even though the evidence suggests neonatal circumcision may reduce the risk ten-fold, the rarity of the condition is such that universal circumcision is clearly not justified on these grounds." -- The Royal Australasian College of Physicians. Policy Statement On Circumcision. Sep 2002.

DanBlackham 08:54, 30 Sep 2004 (UTC)

So? Williamb 09:00, 30 Sep 2004 (UTC)

The fact that the AMA and RACP say circumcision is not justified to prevent penile cancer helps to put the following sentence from the article in proper perspective. "It is established that childhood circumcision reduces the incidence of penile cancer." -- DanBlackham 09:27, 30 Sep 2004 (UTC)

  • In the US the stats are 1:100,000 across the general population and 1:600 among the uncircumcised. The AMA's opinion was that to address the risk of penile cancer alone circumcision is not justifed. That is fine and should be included. Now why did you tamper with the stats? The next question would be why Theresa aided and abetted this act by reverting to your edit?~It is just gets stranger and stranger. - Friends of Robert 03:39, 1 Oct 2004 (UTC)

" Indeed, the incidence of penile cancer has been reported to be falling in uncircumcised men. In a recent study, a decreasing penile cancer rate of 0.82/100 000 was found in Denmark (where circumcision is uncommon) compared with an incidence of 1/100 000 in the USA " [1] Theresa Knott (The torn steak) 05:23, 1 Oct 2004 (UTC)

[edit] Penile cancer is rare

Penile cancer is rare according to the following organizations:

  • American Cancer Society: "Penile cancer is very rare in North America and Europe."
  • American Academy of Pediatrics: "Cancer of the penis is a rare disease; the annual age-adjusted incidence of penile cancer is 0.9 to 1.0 per 100 000 males in the United States. In countries where the overwhelming majority of men are uncircumcised, the rate of penile cancer varies from 0.82 per 100 000 in Denmark to 2.9 to 6.8 per 100 000 in Brazil93 and 2.0 to 10.5 per 100 000 in India."
  • American Medical Association: "Penile cancer is a rare disease in the United States (0.9 to 1 per 100,000)."
  • The Royal Australasian College of Physicians: "Carcinoma of the penis is a rare condition, with an annual incidence of approximately 1:100,000 men in developed countries, regardless of whether there is a high or a low circumcision rate."

In my opinioin article should include a sentence that says penile cancer is rare in developed countries. -- DanBlackham 22:53, 30 Sep 2004 (UTC)

    • Show us the cite then we can see if it deserves to be included. - Friends of Robert 03:39, 1 Oct 2004 (UTC)

The above quotes from the American Cancer Society, American Academy of Pediatrics, American Medical Association, and The Royal Australasian College of Physicians all say that penile cancer is rare. Statements made by those organizations deserve to be included in the article, especially when they all agree. -- DanBlackham 09:10, 1 Oct 2004 (UTC)

[edit] The Royal Australasian College of Physicians policy on circumcision

Robert added the word "alone" to the following sentence.

"The American Medical Association and the Royal Australasian College of Physicians say the use of infant circumcision to prevent penile cancer alone in adult men is not justified."

However in my opinion the following quotes from The Royal Australasian College of Physicians Policy Statement On Circumcision do not support that addition.

  • "After extensive review of the literature the RACP reaffirms that there is no medical indication for routine male circumcision." (emphasis in original document)
  • "The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit."
  • "Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure."

DanBlackham 09:10, 1 Oct 2004 (UTC)

[edit] Incidence rate in uncircumcised men

Both the American Medical Association and the Canadian Paediatric Society say the annual incidence rate of penile cancer in uncircumcised men in the United States is 2.2 in 100,000 not 1 in 600.

Both the AMA and CPS cite the article by Kochen and McCurdy to support the 2.2 in 100,000 figure.

  • Kochen M, McCurdy S. Circumcision and the risk of cancer of the penis. A life-table analysis. Am J Dis Child. 1980;134:484-486.

DanBlackham 09:52, 1 Oct 2004 (UTC)

    • Did you read the abstract of Kochen/McCurdy? [2] Seeing is believing. Then a brain teaser for you. The CPS gives the hint. What is the difference between 1:100,000 and 1:100,000 per year? - Friends of Robert 17:08, 1 Oct 2004 (UTC)

[edit] Why I removed the 1 in 600 quote

We can't put a one in 600 whole of lifetime figure next to an annual incidence rate in the article. It is misleading in the extreme because to a casual reader who may well not pick up on Robert Brooke's little brainteaser above it looks as if circumcising drastically reduced the incidence of penile cancer. I've removed it from the article for now. If someone wants to add it back in in such a way as to make it crystal clear that the two figures cannot be directly compared then I won't redelete it. Theresa Knott (The torn steak) 17:30, 1 Oct 2004 (UTC)

  • Boy, am I glad that you are starting to show some sensitivity towards how information may be interpreted by laymen readers who can not pick up the nuances. How I wish that you would apply that to other articles where you insist upon inserting or allowing the insertion of POV pushing material. I would like you to now reconsider your pushing of the link to NORM (as a sort of free advert) in the Frenulum article (and much more). You have now proved that you have this sensitivity and to fail to apply this elsewhere will serve to prove your bias. - Friends of Robert 03:59, 2 Oct 2004 (UTC)
  • As to the edit. I am not happy that you wish to delete a fact from Wikipedia. This is tantamount to deliberately concealing the truth. This is naughty. If you are are worried about (as you obviously are) that the lack of circumcision is recognised as increasing the risk of Invasive Penile Cancer (IPC) that is not grounds for censoring an article. I will relook at the word order to make sure the facts are clearly stated but take into account your horror at the the thought that people may find out the the presence of a foreskin is a specific health risk. - Friends of Robert 03:59, 2 Oct 2004 (UTC)

"Specifically in the United States the lifetime risk of an uncircumcised man for developing invasive penile cancer (IPC) is one in 600, which is several times higher than for males neonatally circumcised"

This isn't good enough. We need the actual lifetime risk for a circumcised man. I can't see it in the source Robert Brookes cited. Theresa Knott (The torn steak) 07:33, 2 Oct 2004 (UTC)
  • Isn't good enough for whom? I sincerely hope that this heralds a change in approach from you in so far as you will now start to show similar consistency to the "other" side of the debate. Now if you don't ... what would that tell us? - Friends of Robert 09:08, 2 Oct 2004 (UTC)
Just cite the source for circumcised men and it'll stay. How hard is that? (No pun intended) Mike H 09:14, Oct 2, 2004 (UTC)
  • Hi Mike. Congrats on your recent appointment as an admin. Do us a favour and keep an eye on Theresa will you? There appears to be a genuine problem with bias there. Hard work is needed to knock these circumcision related articles into shape. Oh yes ... added a few cites. - Friends of Robert 09:27, 2 Oct 2004 (UTC)

[edit] Keeping things in perspective

In my opinion the fact that the American Cancer Society estimates that in 2003 twice as many men in the United States died from male breast cancer (400) as died from penile cancer (200) helps the article to keep things in perspective. -- DanBlackham 10:36, 2 Oct 2004 (UTC)

Objectively, it makes it sound like penile cancer is less important than male breast cancer. Mike H 10:45, Oct 2, 2004 (UTC)
  • Is the insertion of this gem of information designed to make the 200 or so uncircumcised men who are to die in the US every year feel better? Or is it a desperate attempt to play down the fact that there is an increased risk for uncircumcised men of developing invasive penile cancer? The test will no doubt be the content of other cancer related articles inserted before this issue arose here where it was "found" necessary to place the incidence of a particular cancer in context with others as is being suggested here. - Friends of Robert 11:28, 2 Oct 2004 (UTC)

[edit] evidence

There should be a list of signs and symptoms associated with penile cancer on this page. Scorpionman 12:51, 5 October 2005 (UTC)

[edit] Cleanup

This article is messy, particularly the Risk section. It looks ridiculous to have 6 or 7 sources cited for one sentence, and to have sentences contradicting each other and with the same information being repeated several times. This article should not be a verbatim record of a debate. It should represent a synthesis of the available reliable sources, presenting opposing arguments without undue weught. -- Donald Albury 11:47, 19 October 2006 (UTC)

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