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Lawrence D. Freedman, MD
JAMA. 1970;214(12):2194. doi:10.1001/jama.1970.03180120066018.
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To the Editor.—  In order to determine whether smegma is carcinogenic the author first cites conflicting studies. To determine if "smegma is indeed carcinogenic," he says "... Fishman's group injected smegma from old men into the vaginas of mice two to three times weekly for 12 months and was unable to stimulate the production of genital cancers..." The implication that smegma is not carcinogenic in humans was obviously not proved.In discussing Gagnon's data showing the absence of cervical carcinoma in Catholic nuns the author states that "It would appear that the decisive factor in the nuns' freedom from cervical cancer is related not to the presence or absence of the foreskin, but to the absence of sexual relations." We must disagree with the author's inference. The rarity of cervical carcinoma in persons who abstain from coitus obviously involves several factors. There is no mechanical irritation of the cervix, the cervix


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