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BACK TO SCHOOL

Circumcision

Continued from preceding page

points out, however, that
"these studies in Army hospi-
tals are retrospective in
design and may have metho-
dologic flaws. For example,
they do not include all boys
born in any single cohort or
those treated as outpatients,
so the study population may
have been influenced by selec-
tion bias."

Phimosis. At birth, a
baby's foreskin is firmly at-
tached to his penis; within
the first two years, however,
the layers begin to separate,
until the foreskin can be free-
ly retracted. In rare cases, the
foreskin remains tight as the
child approaches puberty, and
phimosis — the inability to
retract the foreskin — results.
In addition to causing severe
pain and hygienic problems,
phimosis interferes with erec-
tion and occasionally pre-
cludes it altogether. Obvious-
ly, circumcision prevents phi-
mosis entirely, just as it
excludes paraphimosis —
swelling from accumulated
fluids — and balanoposthitis
— inflammation of the fore-
skin and glans. When these
conditions afflict a mature
man, the remedy is circumci-
sion, and what might have
been a minor procedure in a
baby becomes painful surgery
in an adult.

Cancer. Uncircumcised
men very rarely develop
penile cancer; circumcised
men never do. On the other
hand, female partners of un-
circumcised men often de-
velop cervical cancer, while
the partners of circumcised
men enjoy a far lower in-
cidence. In both cases, the
culprit appears to be human
papillomavirus, which more
frequently invades uncircum-
cised men. Even so, gynecolo-
gists point out that the
strongest predisposing factors
in .cervical cancer are a
history of intercourse at an
early age and multiple sex
partners, not an uncircum-
cised partner.

Hygiene. Most of the
special risks that uncircum-
cised men face, from penile
and cervical cancer to phi-
mosis and increased venereal
disease, result from careless
hygiene.
Given all the evidence in its
favor, it appears likely that
circumcision will again attain
the near-universal popularity
it enjoyed in this country
before 1971. While most doc-
tors hesitate either to pre-
scribe or condemn it flatly,
the majority of pediatricians
will at least take pains to in-
form parents that their ances-
tors might have had the right
idea all along. 1=1