Wikipedia doesn’t seem to support what you’re saying about penile cancer. Japan, Norway, and Sweden have similarly low rate rate (0.001%) as the US, and they don’t circumcise. If the rate is a hundred fold higher in Africa and South America, there may be a very different factor involved.
As for circumcision affecting HIV: I’m going to say this once, and only once, to avoid a flame-war. Circumcision prevents transmission if HIV by making the skin of the penis tougher and more calloused through contact with the environment. This is the same mechanism by which circumcision affects sexual function. (Circumcision for both men and women is advocated by various societies in order to desensitize the organ, as themuslimwoman.com vehemently agrees.)
You’re correct. As with almost all human tumors, the causes of penile cancer are multi-factorial and risks can be additive in an exponential manner. For example, mesothelioma is overwhelmingly more likely when you’re exposed to asbestos and tobacco smoke compared with the “linear” additive effects of each. With good hygiene, uncircumcised males are at little additional risk to penile cancer, but in many societies (where penile cancer does impose a shockingly high disease burden) interrupting the “chain” of cancer development is a legitimate and important public health effort. From one of the gold-standard medical-texts on human pathology, Robbins and Cotran: Pathologic Basis of Disease:
This statement is not supported by the available scientific literature. Rather, circumcision seems to offer its protective benefits by removing tissue expressing high levels of CD4+ cells, which is a well characterized cellular receptor integral to the HIV infection pathway.
I’ll let that thoughtful observation stand for public scrutiny and future reference. But aren’t you the individual who scolded me and then demanded to me that no debate take place here, complete with a confrontational, forehead-smacking smilie? Hmmm…
Far be it from me to express even the slightest skepticism concerning a reference from Wikipedia, that great bastion of scholarly, authoritative knowledge written by anyone at all with an interest in shaping others’ beliefs and opinions (I’m looking at you, too, Colbert!), but if you had looked a bit deeper into the American Cancer Society link the Wikipedia article cites (for just one example), you would have found this, dated July 2008:
But even that isn’t completely on point in reference to my post in which I cited the conclusions of peer-reviewed scientific research, because I was not so foolish as to address or limit my comments on penile cancer rates in regard to the advanced Western countries, where no one doubts penile cancer rates are very low. Instead, I reported:
These facts I reported are in no way called into question by the ACS statement you quoted because the above are simply observational reports. I did not include a claim of a direct, unambiguous cause-and-effect relationship between lack of circumcision and penile cancer, as I well understand that correlation is not proof of causation. To have done so would have been controversial and thus open to debate, and therefore would not have been appropriate in GQ.
But the penile cancer issue is minor and by no means approaches in urgent importance the primary health issues related to the scientifically established health benefits of circumcision, and that is circumcision’s considerably powerful preventive effectiveness against HIV and other STDs.
You write:
Let us first note that you provided no scientific credible evidence – no evidence at all, for that matter – for your… well, let’s just call them “assertions”. And is that weren’t enough, it is telling that you did not hesitate to employ nakedly emotional, fallacious guilt-by-association tactics by trying to link the scientific facts regarding male circumcision to utterly barbaric extreme-sect religious dogma with no basis in science whatsoever.
In any event, your claims are misleading and inaccurate to say the least. The powerfully preventive effects of circumcision, or conversely the powerful increase in risks arising from the lack of circumcision, arise chiefly from the following factors in decreasing order of significance:
(1): The most important factor is that the foreskin greatly increases risk of HIV infection due to the high density of HIV target cells residing in even the cleanest foreskin… (Weiss HA. Male circumcision as a preventive measure against HIV and other sexually transmitted diseases. Curr Opin Infect Dis. 2007 Feb;20(1):66-72.) This has nothing whatsoever to do with “making the skin of the penis tougher and more calloused” and it has nothing to do with sexual pleasure.
(2): A less important factor (which you inaccurately referred to) is the lack of keratinization of the inner mucosal surface of the uncircumcised penis. Keratinization in this context refers to the very slight thickening of the skin and glans of the penis that results from circumcision. This keratinization in the case of the circumcised penis is slight indeed and is in no way comparable to a “callous”. There is nowhere on the circumcised penis that looks or feels any less flexible and soft to another’s touch than an uncircumcised one.
As for scientific evidence regarding alleged loss of sexual pleasure resulting from circumcision, consider the following peer-reviewed study, which has now been replicated several times with the same results:
Yet as someone who has investigated and followed the circumcision debate for many years, I’ve read several credible reports that a small but real reduction in the extreme sensitivity to touch in the circumcised penis does occur in some cases. Interestingly, the overwhelming majority of these men – who were circumcised as adults and thus are in the best position to judge – find this to be a highly desirable change!
Why? Because the extreme sensitivity of their uncircumcised penises forced them to be substantially less vigorous and less adventuresome and energetic lest that greater sensitivity “set them off” too quickly!
There is far more evidence in favor of circumcision I could report, but that’s all for now.
Since some might see an apparent contradiction in my previous post regarding the issue of differences between circumcised and uncircumcised men in terms sexual sensation and satisfaction, I’ll expand on my comments in order to resolve the appearance of a contradiction.
The scientific conclusions expressed in the J.N. Krieger, et al paper noted that, of those reporting any difference in sensation after circumcision, a clear majority of them reported that their penis was “much more sensitive,” and 54.5% rated their ease of reaching orgasm as “much more”. (I should have revised my square-bracketed summation to read: "The rest either reported “more” (as opposed to “much more”) or reported no difference.)
But I also stated that
The following additional data need be considered to reveal that the contradiction is merely apparent and not real:
You see, some men complain that for a while after their circumcisions, the pleasure deriving from their newly cut penis can sometimes be excessive. This is because formerly, their glans was usually covered in part by their foreskin (some foreskins never retract completely, even during sexual relations), but when it was removed, the sensitive glans was over-stimulated compared to their prior state (i.e., the foreskin no longer preventing them from experiencing maximum pleasure). The full exposure of the glans is of paramount importance to sexual pleasure, thus hiding it even partially under the foreskin would result in less net pleasure. (Note that this particular comment is in regard only to those men whose foreskin does not retract completely, not to all uncircumcised men).
However, once the keratinization process described in my previous post completes, the extreme level of pleasurable sensation subsides to more manageable levels. But it remains significantly higher than when they were uncircumcised, which makes perfect sense. After all, would a given man prefer a thick layer of foreskin interfering with their pleasure, or only the very slight thickening resulting from keratinization? I know which way I’d decide…
Ignoring the digression on the benefits or otherwise of circumcision…
I’m still interested in the question Mangetout posed.
I had (apparently) a partial circumcision as an infant, so I have a foreskin that covers the glans when flaccid. When erect, the glans is fully exposed, and the skin of the foreskin is flat on the erect shaft. It is obvious where the inner side of the foreskin (in contact with the glans when flaccid) ends, and the outer side of the foreskin begins. To my observation, the points on the inner and outer surfaces that are closest when flaccid (where the circumcision cut would be) are separated by the full length of the foreskin when fully erect and retracted. It seems to me that any connective tissue between the inner and outer surfaces must be stretchy enough to allow this level of extension.
I am guessing that for an infantile circumcision, erection and retraction are unlikely to occur, so that the inner and outer surface heal in close proximity with a minimal scar. In adults, however, where erection is more likely to occur, the inner and outer surfaces are stitched to keep them in proximity and reduce scarring.