Snip/Tuck?

A bit of skin has been the subject of heated debate for the last hundred years. The prepuce, or foreskin, is that fold of skin that covers the tip of the penis. Removal of the foreskin is called circumcision, and therein lies the rub, so to speak.

While circumcision rates in Britain have dropped to less than 1 percent, circumcision remains the most commonly performed surgical procedure in the United States. Traditionally, the main argument for circumcision has been the prevention of sexually transmitted diseases which may lead to cervical cancer in future sexual partners. But is this a valid reason for the surgery? Proponents on both sides of the argument are clamoring since a controversial study appeared in the New England Journal of Medicine.

Xavier Castellsague, M.D., of the Llobregat Hospital in Barcelona, Spain, reviewed seven previously published studies involving 1,913 couples that looked at the risk of developing cervical cancer by women with circumcised partners versus those with uncircumcised partners. His analysis concluded that, "in the case of men with a history of multiple sexual partners, [circumcision conferred] a reduced risk of cervical cancer in their current female partners."

Also, two large, carefully controlled, randomized clinical trials of 3,000 HIV-negative South Africa men, ages 18 to 24, found that circumcision reduces the risk that men will contract HIV -- the virus that causes AIDS -- through intercourse with infected women by a whopping 70 percent. In fact, the study was stopped because an independent monitoring board determined the treatment so effective that it would be unethical to continue it.

So what's the verdict? Parents need to take all these factors into consideration. "I still think it's a personal decision," says Tony Wayne, M.D., attending pediatrician at Yale New Haven Hospital.