While a recent AAP policy statement supports the practice of newborn male circumcision, it appears that the rates of the procedure in the U.S. are declining. A study published in this month’s Mayo Clinic Proceedings demonstrates a decrease from 83% in the 1960’s to 77% in 2010.
The AAP’s position is that the benefits of circumcision outweigh the risks, and that the benefits justify access to — and insurance payments for — the procedure.
Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV.
The policy statement urges pediatricians to “routinely inform parents of the health benefits and risks of male newborn circumcision in an unbiased and accurate manner.” The Mayo Clinic report has a detailed list of the pros and cons, including a 15-20% higher rate of prostate cancer in uncircumcised adult men.
Like those who equate circumcision with male genital mutilation, Andrew Sullivan notices the trend of declining circumcision rates:
That’s a big shift away from the expectations of the past. It will surely provoke more questioning of the strange, ancient, religious practice as routine medical care in the US.
Linda Carroll suggests that doctors and parents should look at circumcision the same way as vaccinations:
Parents might be hesitant to get their newborn sons circumcised, but they should recognize it as surgery that will improve health.
“If parents don’t want to vaccinate we ask why. And then we explain why it’s beneficial,” said Dr. John M. Fisch, director of Womancare at Magee-Womens Hospital. “Doctors haven’t done that with circumcision. They’ve basically left it up to parents. This report suggests we need to educate more, especially among those groups who may not understand why it’s beneficial.”
The study’s authors agree:
[I]n our view, it might be an appropriate time for governments, insurers, and the medical profession to act. When considered together with ethical and human rights arguments, neonatal circumcision should logically be strongly supported and encouraged as an important evidence-based intervention akin to childhood vaccination.
Still, the AAP’s position is to leave the decision of whether or not to circumcise to parents:
Parents ultimately should decide whether circumcision is in the best interests of their male child. They will need to weigh medical information in the context of their own religious, ethical, and cultural beliefs and practices. The medical benefits alone may not outweigh these other considerations for individual families.
More PediaBlog on newborn male circumcision here.