Should routine neonatal circumcision be a police to prevent penile cancer? | Opinion: Yes

This theme is controversial because no major medical organization recommends universal neonatal circumcision and no major medical organization calls for banning it either. The argument that this procedure must be kept within the purview of medical pro-fessionals is found across all major medical organizations. In addition, the organizations advise medical professionals to yield to some degree to parents’ preferences, commonly based in cultural or religious views, in the decision to agree to circumcise (1). Circumci-sion may be used to treat pathological phimosis, refractory balanoposthitis and chronic, recurrent urinary tract infections (2, 3). Circumcision is contraindicated in infants with certain genital structure abnormalities, such as a misplaced urethral opening (as in hy-pospadias and epispadias), curvature of the head of the penis (chordee), or ambiguous genitalia, because the foreskin may be needed for reconstructive surgery. Circumcision is contraindicated in premature infants and those who are not clinically stable and in good health (3-5). If an individual, child or adult, is known to have or has a family history of serious bleeding disorders (hemophilia), it is recommended that the blood be checked for normal coagulation properties before the procedure is attempted (3, 5). A 2010 review of literature worldwide found circumcisions performed by medical providers to have a me-dian complication rate of 1.5% for newborns and 6% for older children, with few cases of severe complications (6). Bleeding, infection and the removal of either too much or too little foreskin are the most common complications cited (6). Complication rates are higher when the procedure is performed by an inexperienced operator, in unsterile conditions, or when the child is at an older age (6). Circumcision does not appear to have a negative impact on sexual function (7). The practice of neonatal circumcision exerts a protective factor avoiding the genesis of penile cancer. While the presence of phimosis is a strong risk factor for peni-le cancer, neonatal circumcision appears to be a protective factor (8, 9). The incidence of penile cancer in the Jewish population, where the practice of neonatal circumcision is universally practiced, approaches zero. There are only 9 reports of penile cancer in circumcised Jews in the neonatal period, reported in the world literature. Interestingly,