Editing CUA: Circumcision (2018) (section)

== Circumcision and the risk of penile cancer ==

* '''Circumcision decreases the risk of penile cancer'''
* '''However, given the low incidence of invasive penile cancer, the partial protective effect of MC, and the availability of other preventive strategies''', such as HPV vaccination, condom use, and smoking cessation programs, '''it is difficult to justify universal neonatal circumcision as a preventive strategy for preventing penile cancer'''
* Recognition and treatment of phimosis during regular health visits is recommended to decrease the risk of penile cancer.
** A genitourinary exam during puberty is recommended to ensure preputial retractability and hygiene, rule out phimosis, and counsel regarding HPV vaccination and safe sexual practices, as well as to offer the possibility of circumcision as a preventive measure against STIs while specifying the drawbacks and efficacy of other preventive measures
* There is no convincing evidence on the protective effect of MC against prostate cancer
* '''There is lack of any convincing evidence that neonatal circumcision will impact sexual function or cause a perceptible change in penile sensation in adulthood'''

'''See Table 2 from Original Guideline'''

'''In an overall societal perspective, given our healthcare system and the socioeconomic and educational status of our population, universal neonatal circumcision is not justified based on the evidence available.'''