Monday, August 27, 2012

New Statement from the American Academy of Pediatrics on Circumcision

Today, the American Academy of Pediatrics (AAP) has released a new Circumcision Policy Statement. This release is an update to their last statement in 1999, reaffirmed in 2005.

I've linked to the primary sources in the medical literature because I think it's the best way to parse out any changes.

Here is a critical passage from today's statement (2012):
"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."

This is a more definite statement when compared to the 1999 statement:
"Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision;"

Today's policy statement explicity highlights the medical benefits of circumcision and notes that overall the benefits outweigh the risks.  However, the statement stops short of recommending the procedure to all males.

The new policy statement's recommendation to have access for the procedure addresses the current lack of coverage for Medicaid subscribers in 18 states.

My analysis:
The circumcision debate has very entrenched camps for and against.  This issue is not simply a medical one.  It also involves the social, spiritual, and religious realms.  As a urologist by trade, my expertise lies with the medical.  There is burgeoning evidence that is hard to refute as noted in the AAP statement regarding the health benefits of circumcision.  However, ultimately, the decision as to whether or not to circumcise lies with the patient and family whilst receiving the appropriate informed consent from their physicians.  Families that elect to have circumcision should have appropriate support from insurers to due to its health benefits.  The health benefits of circumcision may cause the procedure to be classified as a preventative service.

Additional references/sources and for further reading:
LA Times Article (Brown)
USA Today Article (Painter)

1 comment:

  1. Good commentary Ron. This is such an incredibly hot topic (for reasons that are somewhat beyond me), but it is good for people to know that there is some evidence to take into consideration when making their decision.