Influential AAP Says Health Benefits Of Circumcision Trump Risk

The American Academy of Pediatrics new policy statement today asserting that the health benefits of male circumcision outweigh the risks will inevitably set off a firestorm of reaction. Even while the pediatrics group continued to reiterate in their paper that circumcision is a personal family decision best left up to "parents in consultation with their child's doctor" folks who oppose the procedure and equate it with genital mutilation will certainly not be pleased.

Carey's earlier post on the increased health costs associated with declining circumcision rates triggered scary and intense online outrage.

All I can say is I'm glad I have daughters.

Here's the abstract from the AAP paper today:

Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV.

The American College of Obstetricians and Gynecologists has endorsed this statement. (My bold)

And here's a little more explanation via press release:

Since the last policy was published, scientific research shows clearer health benefits to the procedure than had previously been demonstrated. According to a systematic and critical review of the scientific literature, the health benefits of circumcision include lower risks of acquiring HIV, genital herpes, human papilloma virus and syphilis. Circumcision also lowers the risk of penile cancer over a lifetime; reduces the risk of cervical cancer in sexual partners, and lowers the risk of urinary tract infections in the first year of life.

The AAP believes the health benefits are great enough that infant male circumcision should be covered by insurance, which would increase access to the procedure for families who choose it.

“Ultimately, this is a decision that parents will have to make,” said Susan Blank, MD, FAAP, chair of the task force that authored the AAP policy statement and technical report. “Parents are entitled to medically accurate and non-biased information about circumcision, and they should weigh this medical information in the context of their own religious, ethical and cultural beliefs.”

The medical benefits alone may not outweigh other considerations for individual families. The medical data show that the procedure is safest and offers the most health benefits if performed during the newborn period. The AAP policy recommends infant circumcision should be performed by trained and competent providers, using sterile techniques and effective pain management.

The policy has been endorsed by the American College of Obstetricians and Gynecologists (the College). “This information will be helpful for obstetricians who are often the medical providers who counsel parents about circumcision,” said Sabrina Craigo, MD, the College’s liaison to the AAP task force on circumcision. “We support the idea that parents choosing circumcision should have access to the procedure.”

Parents who are considering newborn circumcision should speak with their child’s doctor about the benefits and risks of the procedure, and discuss who will perform the circumcision. “It’s a good idea to have this conversation during pregnancy, and to learn whether your insurance will cover the procedure, so you have time to make the decision,” said Dr. Blank.

Readers will this calm the debate or fan it? Let us know.