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The exact cause of penile cancer is unknown.
The myth that [[smegma]] was a carcinogenic, and thus that [[circumcision]] would render a man immune to penile cancer, was invented in 1932 by a man named Abraham L. Wolbarst, who also believed that circumcision prevented epilepsy, paralysis, and [[masturbation]].<ref>Wolbarst A. Circumcision and Penile Cancer. The Lancet, vol. 1 no. 5655 (January 16, 1932): pp. 150-153.</ref> No laboratory or clinical research had been done on the subject at the time, however Wolbarst's myth found its way into early medical textbooks regardless. Although the smegma hypothesis was completely disproven by an exhaustive study by Reddy in 1963,<ref>D.G. Reddy; I.K. Baruah. "Carcinogenic Action of Human Smegma," Archives of Pathology, vol. 75, no. 4 (April 1963): pp. 414-420.</ref> circumcision advocates continue to stubbornly repeat it.
The link between the presence of [[human papillovirus]] (HPV) and genital cancer was established in the 1980s.<ref>zur Hausen H. Genital papillomavirus infections. Prog Med Virol 1985;32:15-21.</ref><ref>Kaufman RH, Adam E: Herpes simplex virus and human papilloma virus in the development of cervical carcinoma. Clin Obstet Gynecol 1986; 3: 678-692</ref><ref>McCance DJ, Kalache A., Ashdown K, et al. Human papillomavirus types 16 and 18 in carcinomas of the penis from Brazil. Int J Cancer 1986:37:55-59</ref><ref>Villa LL, Lopes A. Human papillomavirus DNA sequences in penile carcinomas in Brazil. Int J Cancer 1986;37(6):853-5.</ref><ref>McCance DJ. Human papillomaviruses and cancer. Biochem Biophys Acta 1986;823:195-206</ref><ref>Barrasso R, De Brux J, Croissant O, et al. High prevalence of papillomavirus-associated penile intraepithelial neoplasia in sexual partners of women with cervical intraepithelial neoplasia. N Engl J Med 1987 Oct 8;317(15):916-23.</ref> Poland identified human papilloma virus (HPV) types 16 and 18 as the cause of penile and cervical cancers in 1990, and that they could be spread by sexual contact.<ref>Poland RL. The question of routine neonatal circumcision. N Eng J Med 1990; 322:1312-5.</ref> At least one study suggests that circumcised men are at higher risk for HPV infection,<ref>Cook LS, Koutsky LA, Holmes KK. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic. Genitourin Med 1993;69:262-4</ref> making being circumcised a risk factor.
== Circumcision as prevention ==
The myth that circumcision rendered males immune to penile cancer was invented in 1932 by a man named Abraham L. Wolbarst, M.D.<ref>Wolbarst, AL. Circumcision and penile cancer. Lancet 1932; 150-3.</ref> Wolbarst wrote an article that was published in the Lancet in 1932, implicating human male [[smegma]] as carcinogenic.<ref>Wolbarst A. Circumcision and Penile Cancer. The Lancet, vol. 1 no. 5655 (January 16, 1932): pp. 150-153.</ref> His hypothesis had absolutely no basis in valid scientific and epidemiological research.<ref>Fleiss PM, Hodges F. Neonatal circumcision does not protect against cancer. BMJ 1996;312(7033):779-80.</ref> Wolbarst was directly responsible for proliferation of this myth, and all subsequent repetions of it can be traced to his opinion article, although Wolbarst himself advocated universal neonatal circumcision principally as a preventive for epilepsy, paralysis, and [[masturbation]].<ref>Fleiss PM, Hodges F. Neonatal circumcision does not protect against cancer. BMJ 1996;312(7033):779-80.</ref>
Wolbarst's opinion piece led to the perpetuation of the myth that penile cancer could not happen to males that were circumcised in infancy. This myth was completely disproven when Boczko et al. reported the 9th documented case of penile cancer in a man who had been circumcised in infancy from the time of Wolbarst's opinion piece to the time of the report in 1968 (though they would maintain that "performing [circumcision] in infancy continues to be the most effective prophylactic measure against penile carcinoma").<ref>Boczko S, Freed S. Penile carcinoma in circumcised males. N Y State J Med 1979; 79(12):1903-4.</ref> Boczko et al. wrote: ''"The diagnosis in our patient was made late, as in the other cases reported, perhaps because the disease was presumed not to occur in those circumcised in infancy. This is clearly not so. Although rare, the diagnosis must be considered when evaluating a penile lesion even in a circumcised individual."''