Circumcision

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In males, circumcision is the surgical removal of the foreskin which covers the head of the penis. This operation is usually performed early in a child's life. Circumcision is a common practice not only in the United States and the Middle East, but throughout the world and history. It is generally not practiced in most of Europe and largely unheard of in Eastern Asian countries. Ritual circumcision is common in the Jewish and Islamic faiths, but uncommon altogether in Asia, South and Central America, and most of Europe.[1] Circumcision was an outward sign of the covenent between God and the Jewish people as told in the Bible in the book of Genesis.

According to the American Cancer Society:

Circumcision removes all (or part) of the foreskin. This procedure is most often done in infants, but it can be done later in life, too. Men who were circumcised as children may have a much lower chance of getting penile cancer than those who were not. In fact, some experts say that circumcision as an infant prevents this cancer. The same protective effect is not seen if circumcision is done as an adult.

The reason for the lower risk in circumcised men is not entirely clear, but it may be related to other known risk factors. For example, men who are circumcised can’t develop the condition called phimosis, and they don’t accumulate material known as smegma (see the next section). Men with smegma or phimosis have an increased risk of penile cancer. The later a man is circumcised, it's more likely that one of these conditions will occur first.

In weighing the risks and benefits of circumcision, doctors consider the fact that penile cancer is very uncommon in the United States, even in uncircumcised men. Although the American Academy of Pediatrics has stated that the health benefits of circumcision in newborn males outweigh the risks, it also states these benefits are not great enough to recommend that all newborns be routinely circumcised. In the end, decisions about circumcision are highly personal and often depend more on social and religious factors than on medical evidence.[2]

Circumcision rates in the US have been declining since 1965, due in part to statements from the American Academy of Pediatrics[3][4][5] and the American Medical Association [6] discouraging the practice. While it varies regionally, in 2004 about 57% of newborn boys in the US were circumcised.[7]

The procedure lasts only ten minutes and is often performed in a hospital before the baby is taken home. Local anesthesia and antibacterial ointment are used to prevent pain and infection. Some boys may experience a small amount of bleeding or redness, and this is a normal part of the procedure.

Medical Benefits

The medical benefits suggested to accrue from circumcision are:

  • Reduced incidence of urinary tract infection in infant males
  • Reduced incidences of infection in prolonged exposure to non-hygenic conditions as might take place during war
  • Decreased incidence of penile cancer in adult males
  • Decreased susceptibility to certain sexually transmissible diseases, including human immunodeficiency virus (HIV). Studies taken in the African nations of Kenya and Uganda found that circumcised males were less than half as likely to acquire HIV when involved in intercourse with an infected partner than those who were never circumcised.[8]

AMA Response

Despite these benefits, the AMA does not recommend routine infant circumcision. They state that because the incidence of urinary tract infection in infant males is low to begin with, circumcision is not justified as a preventive measure against this condition; because penile cancer is rare and occurs later in life, the use of circumcision as a preventive practice is not justified; and because behavioral factors are far more important risk factors for acquisition of HIV and other sexually transmissible diseases than circumcision status, circumcision cannot be responsibly viewed as "protecting" against such infections. The AMA concludes that "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."[9]

Female Circumcision (FGM)

Female circumcision, practiced in parts of Africa, is a much different procedure that can have lasting effects on a girl's health.[10] The procedure may range from a simple cut in the pubic region to the complete removal of parts of the female reproductive organs. While the procedure is an important part of some African cultures, there is increased pressure by women's groups worldwide to ban it. Female circumcision is often referred to in the medical community as Female Genital Mutilation, or FGM.[11]

Atheism, Judaism, circumcision and penile cancer

See also: Atheism, circumcision and penile cancer and Atheism and penile cancer and The Bible and health

The prophet Moses authored the book of Leviticus

Max Neuberger, writing in his "History of Medicine" states concerning the Mosaic laws:

The commands concern prophylaxis and suppression of epidemics, suppression of venereal disease and prostitution, care of the skin, baths, food, housing and clothing, regulation of labour, sexual life, discipline of the people, etc. Many of these commands, such as Sabbath rest, circumcision, laws concerning food (interdiction of blood and pork), measures concerning menstruating and lying-in women, and those suffering from gonorrhoea, isolation of lepers, and hygiene of the camp, are, in view of the conditions of the climate, surprisingly rational.[12]

The 2017 medical journal article entitled Incidence of penile cancer worldwide: systematic review and meta-analysis published in the Revista Panamericana de Salud Pública/Pan American Journal of Public Health declared: "In contrast, rates among Jewish men born in Israel are reportedly very close to zero."[13]

Circumcision and the rarity of penile cancer in the United States and South Korea

The United States is a religious country (see: United States, irreligion vs. religion and demographics and Sociology of "atheism is un-American" view and American atheism).

Wikipedia, an online encyclopedia founded by an atheist and agnostic, indicated in 2020:

The United States is an outlier with regards to other predominately Christian Western nations. As of 2007, fifty-five percent of newborn males were circumcised, a significant decline from years past. Countries like Australia and Canada have much lower rates of circumcision, and the United Kingdom is considering an outright ban.[14]

The 2019 medical journal article Single-Center Analysis of Human Papillomavirus Infection and P16INK4A Expression among Korean Patients with Penile Cancer published in Biomed Research International states: "The overall incidence in the US is approximately 0.69 cases/100,000 people, although this rate increases with an increasing age at diagnosis. In Korea, primary penile cancer is both rare and rarely reported, accounting for only 74 cases in 2015, which corresponded to only 0.03% of all malignant tumors during that year."[15]

The 2002 journal article entitled Extraordinarily high rates of male circumcision in South Korea: history and underlying causes states:

Currently the circumcision rate for high-school boys is >90% and for those >70 years old is <10%. The circumcision rate in 1945 was <0.1%. When averaged over the whole population, the present South Korean circumcision rate is ~60%; the rate has increased dramatically with time and particularly in the past 20 years, when the estimated number of male circumcisions has exceeded the number of male births. Although circumcision in South Korea has been strongly influenced by American culture, it has never been predominantly neonatal."[16][17]

In 2011, NBC New York reported that penile cancer in the United States was "rare".[18]

Secular Europe and circumcision

See also: Atheism and penile cancer and Secular Europe

From a global perspective, Europe is more secular/atheistic than the rest of the world although it does have a considerable amount of religious immigrants who have higher birth rates (see: Secular Europe and Atheist population and Global atheism).

In 2012, the BBC reported in an article entitled Circumcision, the ultimate parenting dilemma:

While Europe increasingly questions the practice of circumcising boys, US paediatricians are about to say that the medical case for it is getting stronger. Most US adult men are circumcised, but the number of newborns having the op is falling, and is now below 50% in some states - intensifying the dilemma for parents.[19]

Wikipedia, an online encyclopedia founded by an atheist and agnostic, indicates:

On 1 October 2013, the Parliamentary Assembly of the Council of Europe adopted a non-binding resolution in which they state they are "particularly worried about a category of violation of the physical integrity of children," and included in this category "circumcision of young boys for religious reasons." On 7 October, Israel's president Shimon Peres wrote a personal missive to the Secretary General of the Council of Europe, Thorbjørn Jagland, to stop the ban, arguing: "The Jewish communities across Europe would be greatly afflicted to see their cultural and religious freedom impeded upon by the Council of Europe, an institution devoted to the protection of these very rights." Two days later, Jagland clarified that the resolution was non-binding and that “Nothing in the body of our legally binding standards would lead us to put on equal footing the issue of female genital mutilation and the circumcision of young boys for religious reasons.”[20]

A number of male circumcision bans have been proposed by various Europeans.[21]

England/Wales/United States/Australia, male circumcision and penile cancer

A study reported that England and Wales had the highest incidence and mortality rates of penile cancer compared to Australia and US and also the lowest infant circumcision rates and overall circumcision prevalence.[22]

England (highlighted in light green), showing the boundaries of the ceremonial counties.

As noted above, the United States is a religious country (see: United States, irreligion vs. religion and demographics and Sociology of "atheism is un-American" view and American atheism).

The UK and Australia are more irreligious/nonreligious than the United States (see: British atheism and UK and secularism and Irreligion in Australia).

The 2015 journal article Trends in penile cancer: a comparative study between Australia, England and Wales, and the US reported:

The overall incidence of penile cancer in England and Wales (1.44 per 100,000 man-years) was higher than in Australia (0.80 per 100,000), and the US (0.66 per 100,000). Incidence of penile cancer in all three countries has remained relatively stable over time. Similarly, although the mortality rates were also higher in England and Wales (0.37 per 100,000 man-years) compared to Australia (0.18 per 100,000) and the US (0.15 per 100,000), the mortality/incidence ratios were similar for all three countries.

England and Wales had the highest incidence and mortality rates of penile cancer compared to Australia and US and also the lowest infant circumcision rates and overall circumcision prevalence. This offers some support to previous data suggesting infant circumcision may reduce risk of penile cancer. However, despite having higher circumcision rates in the US, the incidence of penile cancer in Australia and the US were similar, suggesting that the penile cancer incidence is not solely attributable to circumcision rates.[23]

See also: Atheism, bestiality and penile cancer and Bestiality and Britain and Bestiality and Australia

Irreligious Sweden, circumcision and penile cancer

Sweden had a rate of 2.1 people with penile cancer per 100,000 people between the years of 2000-2012 (Sweden is one of the most atheistic counties in the world and the website adherents.com reported that in 2005 46 - 85% of Swedes were agnostics/atheists/non-believers in God.[24]). [25]

Scandinavia is considered to consist of the countries of Norway, Sweden, and Denmark. The male circumcision rate in Scandinavia is approximately 1-2%.[26][27] See also: Bestiality and Sweden

Study: Secular Europe has about twice the rate of penile cancer than the religious United States

Irving Berlin's song God Bless America is a popular American patriotic song written by Berlin in 1918. See: Sociology of "atheism is un-American" view and American atheism

Secular Europe recently had a notable problem with bestiality (see: Bestiality and secular Europe).

As noted above, there is a positive correlation between engaging in bestiality and penile cancer.

In the United States, Pew Research survey data indicates that the percentage of atheists in the United States has remained at 4% from 2015 to July 2019.[28] See: American atheism

The 2017 medical journal article entitled Incidence of penile cancer worldwide: systematic review and meta-analysis published in the Revista Panamericana de Salud Pública/Pan American Journal of Public Health indicated: "Penile cancer is a rare malignancy, especially in developed countries, in which the annual incidence is below 1 case per 100,000 men."[29]

As noted above, penile cancer is rare in the United States.[30]

The 2014 medical journal article Risk Factors and Prevalence of Penile Cancer which was published in the West Indian Medical Journal indicates: "The incidence rate of penile cancer in the USA is 0.58 per 100,000. In Europe, the incidence rate of the disease is 1.33 per 100,000."[31]

A Brazilian study indicates that men who engage in bestiality have twice the rate of penile cancer.[32] Atheism, bestiality and penile cancer

On the other hand, a 2017 metastudy reported that North America (Includes United States and Canada) had a rate of penile cancer cases of .91 people per 100,000 people and Europe had a rate of .90 penile cancer cases per 100,000 people.[33] At the same time, in recent years there has been a very rapid growth of Christianity in eastern/central Europe (see: Central and Eastern Europe and desecularization).

Metastudy on penile cancer and some irreligious/nonreligious countries

A 2017 metastudy on penile cancer reported that: the Socialist Republic of Romania (Marxist-Leninist one-party communist/atheist state) had a 7.2 people with penile cancer per 100,000 people between the years of 1983- 1987; Vietnam (Vietnam has state atheism) had a rate of 2.34 people with penile cancer per 100,000 people between the years of 1991-1993; and Sweden had a rate of 2.1 people with penile cancer per 100,000 people between the years of 2000-2012 (Sweden is one of the most atheistic counties in the world and the website adherents.com reported that in 2005 46 - 85% of Swedes were agnostics/atheists/non-believers in God.[34]). [35]

Soviet Union, Jewish male circumcision and male circumcision

Joseph Stalin's atheistic regime killed tens of millions of people. See also: Atheism and mass murder

The Soviet Union practiced state atheism.

Wikipedia, an online encyclopedia founded by an atheist and agnostic, indicates:

Before glasnost, according to an article in The Jewish Press, Jewish ritual circumcision was forbidden in the Soviet Union. However, David E. Fishman, professor of Jewish History at the Jewish Theological Seminary of America, states that, whereas the heder and yeshiva, the organs of Jewish education, "were banned by virtue of the law separating church and school, and subjected to tough police and administrative actions," circumcision was not proscribed by law or suppressed by executive measures. Jehoshua A. Gilboa writes that while circumcision was not officially or explicitly banned, pressure was exerted to make it difficult. Mohels in particular were concerned that they could be punished for any health issue that might develop, even if it arose some time after the circumcision.[36]

In 1964, A.L. Shabad reported in The Journal of Urology: "In the Union of Soviet Socialistic Republics the incidence of penile cancer has varied in recent years from 0.5 to 1 per cent of cancerous diseases."[37] As noted above, the 2019 medical journal article Single-Center Analysis of Human Papillomavirus Infection and P16INK4A Expression among Korean Patients with Penile Cancer published in Biomed Research International states: "In Korea, primary penile cancer is both rare and rarely reported, accounting for only 74 cases in 2015, which corresponded to only 0.03% of all malignant tumors during that year."[38] (South Korea has adopted the religious United States' practice of male circumcision).

See also

References

  1. AMA report on Neonatal Circumcision
  2. Risk Factors for Penile Cancer
  3. AMERICAN ACADEMY OF PEDIATRICS - Task Force on Circumcision - Circumcision Policy Statement [1]
  4. AAP Press Release - NEW AAP CIRCUMCISION POLICY RELEASED
  5. PEDIATRICS Vol. 103 No. 3 March 1999, pp. 686-693 - AMERICAN ACADEMY OF PEDIATRICS: Circumcision Policy Statement [2]"A statement of reaffirmation for this policy was published on September 1, 2005."
  6. AMA report on Neonatal Circumcision
  7. United States Circumcision Incidence
  8. Time Magazine, December 27th, 2007, Pg. 84
  9. AMA report on Neonatal Circumcision
  10. JAMA Vol. 274 No. 21, December 6, 1995 - Female genital mutilation. Council on Scientific Affairs, American Medical Association [3]
  11. JAMA Vol. 274 No. 21, December 6, 1995 - Female genital mutilation. Council on Scientific Affairs, American Medical Association [4]
  12. Neuburger, Max. History of Medicine. Oxford University Press, 1910, Vol. I, p. 38.
  13. Incidence of penile cancer worldwide: systematic review and meta-analysis, Rev Panam Salud Publica. 2017; 41: e117. Published online 2017 Nov 30. doi: 10.26633/RPSP.2017.117
  14. Religious male circumcision, Wikipedia
  15. Single-Center Analysis of Human Papillomavirus Infection and P16INK4A Expression among Korean Patients with Penile Cancer, Biomed Res Int. 2019; 2019: 6940582. Published online 2019 Mar 26. doi: 10.1155/2019/6940582
  16. Extraordinarily high rates of male circumcision in South Korea: history and underlying causes, BJU INTERNATIONAL, Volume 89: Pages 48-54, January 2002.
  17. Frisch M, Friis S, Kruger Kjaer S, Melbye M. Falling incidence of penile cancer in an uncircumcised population (Denmark 1943-90). Br Med J 1995; 311: 1471
  18. Study Links Bestiality, Penile Cancer, NBC New York
  19. Circumcision, the ultimate parenting dilemma, BBC
  20. Circumcision and law, Wikipedia
  21. Circumcision and law, Wikipedia
  22. Trends in penile cancer: a comparative study between Australia, England and Wales, and the US, Springerplus. 2015; 4: 420. Published online 2015 Aug 14. doi: 10.1186/s40064-015-1191-4
  23. Trends in penile cancer: a comparative study between Australia, England and Wales, and the US, Springerplus. 2015; 4: 420. Published online 2015 Aug 14. doi: 10.1186/s40064-015-1191-4
  24. Top 50 Countries With Highest Proportion of Atheists / Agnostics(Zuckerman, 2005)
  25. Incidence of penile cancer worldwide: systematic review and meta-analysis, Rev Panam Salud Publica. 2017; 41: e117. Published online 2017 Nov 30. doi: 10.26633/RPSP.2017.117
  26. Extraordinarily high rates of male circumcision in South Korea: history and underlying causes, BJU INTERNATIONAL, Volume 89: Pages 48-54, January 2002.
  27. Frisch M, Friis S, Kruger Kjaer S, Melbye M. Falling incidence of penile cancer in an uncircumcised population (Denmark 1943-90). Br Med J 1995; 311: 1471
  28. In U.S., Decline of Christianity Continues at Rapid Pace, Pew Research
  29. Incidence of penile cancer worldwide: systematic review and meta-analysis, Rev Panam Salud Publica. 2017; 41: e117. Published online 2017 Nov 30. doi: 10.26633/RPSP.2017.117
  30. Study Links Bestiality, Penile Cancer, NBC New York
  31. Risk Factors and Prevalence of Penile Cancer, West Indian Med Journal. 2014 Oct; 63(6): 559–560, Published online 2015 Jul 28. doi: 10.7727/wimj.2015.381
  32. Study Links Bestiality, Penile Cancer, NBC New York
  33. Incidence of penile cancer worldwide: systematic review and meta-analysis, Rev Panam Salud Publica. 2017; 41: e117. Published online 2017 Nov 30. doi: 10.26633/RPSP.2017.117
  34. Top 50 Countries With Highest Proportion of Atheists / Agnostics(Zuckerman, 2005)
  35. Incidence of penile cancer worldwide: systematic review and meta-analysis, Rev Panam Salud Publica. 2017; 41: e117. Published online 2017 Nov 30. doi: 10.26633/RPSP.2017.117
  36. Circumcision and law, Wikipedia
  37. Some Aspects of Etiology and Prevention of Penile Cancer, Volume 92, Issue 6, December 1964, Pages 696-702
  38. Single-Center Analysis of Human Papillomavirus Infection and P16INK4A Expression among Korean Patients with Penile Cancer, Biomed Res Int. 2019; 2019: 6940582. Published online 2019 Mar 26. doi: 10.1155/2019/6940582