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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 defender of ritual circumcision 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. [http://www.cirp.org/library/disease/cancer/mccance/ 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. [http://www.cirp.org/library/general/poland/ 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.
Hellberg ''et al''. (1986) identified tobacco use as another risk factor for cancer of the penis.<ref>Hellberg D, Valentin J, Eklund T, Staffan Nilsson. [http://www.cirp.org/library/disease/cancer/hellberg1/ Penile cancer: is there an epidemiological role for smoking and sexual behavior?] ''Brit Med J'' 1987;295(6609):1306-8</ref> The use of tobacco has since been a well established risk factor in cancer of the penis.<ref>Harish K, Ravi R. [http://www.cirp.org/library/disease/cancer/harish/ The role of tobacco in penile carcinoma]. ''Brit J Urol'' 1995;75(3):375-377.</ref><ref>Rogus BJ. Squamous cell carcinoma in a young circumcised man. ''J Urol'' 1987;138(4):861-2.</ref><ref>Maden C ''et al''. History of Circumcision, Medical Conditions, and Sexual Activity and Risk of Penile Cancer. ''Journal of the National Cancer Institute'', vol. 85, no. 1., January 6, 1993, pp. 19-24.</ref>
== Incidence of penile cancer ==
In North America the rate of penile cancer has been estimated to be 1 in 100,000<ref>Cutler SJ, Young JL Jr. Third national cancer survey: incidence data. Bethesda, Md. US Dept of Health, Education, and Welfare, Public Health Service, 1975</ref>. Maden ''et al''. reported penile cancer among a fifth of elderly patients from rural areas who had been circumcised neonatally and had been born at a time when the rate of neonatal circumcision was about 20% in rural populations.<ref>Maden C, Sherman KJ, Beckman AM, Hislop TG, Teh CZ, Ashley RL, ''et al''. [http://www.cirp.org/library/disease/cancer/maden/ History of circumcision, medical conditions, and sexual activity and risk of penile cancer]. ''JNCI'' 1993;85:19-24</ref> Their study also shows that the rate of penile cancer among men circumcised neonatally has risen in the United States relative to the rise in the rate of neonatal circumcision.
Penile cancer is very rare in Europe and North America, occurring in about one in 100,000 men in the latter. It accounts for 0.2% of cancers and 0.1% of deaths from cancer amongst males in the United States. However, in some parts of Africa and South America it accounts for up to 10% of cancers in men.<ref name="titleACS :: What Are the Key Statistics About Penile Cancer?">{{REFweb
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}}</ref> Gardasil has been shown to also be effective in males, and has been approved by the FDA to be marketed as such.<ref name="Bloomberg">Cortez, Michelle Fay and Pettypiece, Shannon. {http://www.bloomberg.com/apps/news?pid=20601202&sid=aajzweDaXZh0&refer=healthcare Merck Cancer Shot Cuts Genital Warts, Lesions in Men]. ''Bloomberg News''. (Bloomberg.com) 13 Nov 2008.]</ref>Two to three doses are necessary.
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