Pediatricians claim circumcision benefits outweigh risks

LINDSEY TANNER, AP Medical Writer

Monday, August 27, 2012

CHICAGO (AP) — The nation's most influential pediatricians group says the health benefits of circumcision in newborn boys outweigh any risks and insurance companies should pay for it.

In its latest policy statement on circumcision, a procedure that has been declining nationwide, the American Academy of Pediatrics moves closer to an endorsement but says the decision should be up to parents.

"It's not a verdict from on high," said policy co-author Dr. Andrew Freedman. "There's not a one-size-fits-all-answer." But from a medical standpoint, circumcision's benefits in reducing risk of disease outweigh its small risks, said Freedman, a pediatric urologist in Los Angeles.

Recent research bolstering evidence that circumcision reduces chances of infection with HIV and other sexually spread diseases, urinary tract infections and penis cancer influenced the academy to update their 13-year-old policy.

Their old stance said potential medical benefits were not sufficient to warrant recommending routinely circumcising newborn boys. The new one says, "The benefits of newborn male circumcision justify access to this procedure for those families who choose it." The academy also says pain relief stronger than a sugar-coated pacifier is essential, usually an injection to numb the area.

The federal Centers for Disease Control and Convention has estimated circumcision costs range from about $200 to $600 nationwide. Coverage varies among insurers and several states have stopped Medicaid funding for circumcisions.

The new policy was published online Monday in Pediatrics. It comes amid ongoing debate over whether circumcision is medically necessary or a cosmetic procedure that critics say amounts to genital mutilation. Activists favoring a circumcision ban made headway in putting it to a vote last year in San Francisco but a judge later knocked the measure off the city ballot, ruling that regulating medical procedures is up to the state, not city officials.

In Germany, Jewish and Muslim leaders have protested a regional court ruling in June that said circumcision amounts to bodily harm.

Meantime, a recent study projected that declining U.S. circumcision rates could add more than $4 billion in health care costs in coming years because of increased illness and infections.

Circumcision involves removing foreskin at the tip of the penis. The procedure can reduce germs that can grow underneath the foreskin, and complications, including bleeding and infection, are rare, the academy says.

Despite the U.S. decline, about half of baby boys nationwide still undergo circumcision, or roughly 1 million each year. The country's overall rate is much higher than in other developed nations, but U.S. rates vary by region and are higher in areas where it is a cultural or religious tradition, including among Jews and Muslims.

Psychologist Ronald Goldman, director of an anti-circumcision group, the Circumcision Resource Center, said studies show circumcision causes loss of sexual satisfaction — a claim the academy said is not supported by the research it reviewed — and can be psychologically harming. Goldman contends medical studies showing benefits are flawed and that the academy's new position is "out of step" with medical groups in other developed countries.

The American Congress of Obstetricians and Gynecologists took part in the research review that led to the new policy and has endorsed it. Circumcisions in hospitals are typically performed by obstetricians or pediatricians.

The CDC also participated in the review, and will consider the academy's updated policy in preparing its own recommendations, a CDC spokesman said. The agency has a fact sheet summarizing circumcision's potential health benefits and risks but no formal guidelines.

The American Medical Association and American Academy of Family Physicians have neutral policies similar to the pediatrics academy's previous position.

Philadelphia social worker Shannon Coyne examined medical research on circumcision before her son was born last September and had a tough time making a decision. She learned that a relative's boy needed reconstructive surgery after a botched circumcision, and that another's son who wasn't circumcised developed urinary infections.

Coyne said she and her husband ultimately decided against circumcision, because she didn't want her baby to have what she considers cosmetic surgery without being able to consent.

Her advice to other parents is "just make an informed decision. Do your research, be open-minded."

Some 18 states have eliminated Medicaid coverage for circumcision, a trend that could contribute to rising health care costs to treat infections if circumcision rates continue to decline, according to a study published Aug. 20 in Archives of Pediatrics & Adolescent Medicine.

Dr. Aaron Tobian, a Johns Hopkins University assistant professor who co-authored the study, said the academy's updated policy "is a very good step."

Online:

American Academy of Pediatrics: http://www.aap.org

CDC: http://1.usa.gov/hJiQj

More like this story

FussyOno 9 months ago

Circumcision is barbaric mutilation and should be banned. Adult men who would not have chosen the proceedure should be allowed to sue the doctors and hospitals who performed this torture with its permanent scar.

him 9 months ago

Thats your personal opinion.

FussyOno 9 months ago

It just happens to be the correct one. Backed up by the apostle Paul who said of those who practice circumcision: "evil workers, beware of those who mutilate the flesh"

JMO 9 months ago

I'm curious, how do you reconcile uoting the Bible and condemning circumscision, a common surgical procedure that has at least some benefits, as mutiliation, with your opinion on another thread that we should, apparently, practice selective breeding of humans to remove "undesireable traits"?

eileen10 9 months ago

As a nurse I've worked first hand with the infections caused from being uncircumcised but it's a matter for the family to decide though for me if I would have had a son I would have opted for circumcision .

eileen10 9 months ago

FussyOno, please read Genesis 17:10-14. God told Abraham to circumcise himself, his slaves etc.

FussyOno 9 months ago

I'll tell you what's abnormal. Cutting off something God intended to be there in the first place. A LOT of Men are incensed that this was done to them without consent. Circumcision can cause complications – bleeding, infection, urethral stricture. Complications may be immediate or delayed, and complications from bleeding, infection and poorly carried out circumcisions can be catastrophic. The immediate complications may be classified as surgical mishap, hemorrhage, infection and anesthetic risk. Deaths have been reported. Necrosis of all or part of the ....., hypospadias, epispadias, impotence and removal of too much tissue, sometimes causing secondary phimosis. Why not let your son make up his own mind later?

eileen10 9 months ago

I don't have a son. i merely stated what God said. It's up to each person if they want to follow Gods word or not.

FussyOno 9 months ago

Not according to the New Testament.

eileen10 9 months ago

Where in the NT

FussyOno 9 months ago

You weary me with your lack of Bible study. You would rather challenge than research yourself because you are committed to your narrow views. But here goes: "I, Paul, am telling you that if you let yourselves be circumcised, Christ will be of no benefit to you. Once again I testify to every man who lets himself be circumcised that he is obliged to obey the entire law. You who want to be justified by the law have cut yourselves off from Christ; you have fallen away from grace." (Gal. 5:2-4) "Beware of the dogs, beware of the evil workers, beware of those who mutilate the flesh! For it is we who are the circumcision, who worship in the Spirit of God…"(Phil. 3:2) "For in Christ Jesus neither circumcision nor uncircumcision counts for anything; the only thing that counts is faith working through love." (Gal. 5:6) Perhaps some of you made a poor decision for your sons. God forgives.

John 9 months ago

Paul's letter to the church at Galatia was to warn people to no long cling to the Jewish teaching that the Savior had not come. He was warning them to not be circumcised to achieve God's favor. It is not intended as a warning to not be circumcised. How do we know this? We know it through CONTEXT -- any Christian Biblical scholar will tell you the Holy Bible translates itself, and one way that is accomplished is via context.

Paul's letter to the church at Phillipi is the same thing. Chapter 3 is even evtitled, "Rightousness through Faith in Christ."

You are quick with text without an understanding of the text. Keep in mind Rev. 22:19, be sure the understanding you are using, especially when you are attempting to convince others to do things NOT specifically in the Bible, is a correct one. If not, I would be hesitant to share it.

eileen10 9 months ago

Juge not lest ye be judged and yes. I do know the Bible.There is contradiction between what Paul taught versus God and Jesus.John 7:21-24 Jesus was circumcised on the eighth day. If God had changed His mind from what He said in the OT He would have inspired Mary and Joseph not to have it done. Other passagesActs 15:1 Romans 2:25. Iheed the words of God and Jesus over Paul. Though Paul didn't like circumcision he spoke of his own accord.

John 9 months ago

First of all, there is NO contradiction in the Bible, at least, not to one who studies it instead of simply reading it. (THAT is not pointed, necessarily, toward you). Jesus was a Jew. Jesus kept all of the Jewish laws. Jesus had not yet been brought to fulfillment. If you like, you might consider this, Jesus did not have a Savior as we know a Savior. He was sent to the Jews and THEN the Gentiles. Therefore, he began life as a Jew and remained a Jew until his resurrection. My writing was not to you, Eileen, unless, of course you find it helpful. God is UNCHANGING. However, Christ did not come to do AWAY with the Law but to FULFILL the Law. ALL of the Holy Bible was written (if you are a Christian) by those who were under the authority of God, therefore, the meanings of the words were what God want them to be. If the meanings of the Bible are NOT to be accepted as the teaching of God, then there is nothing there upon which the Church can base it's Faith. If that is so, then there are no Christians because Christ never came.

MO4LIFE 9 months ago

The bible was written by man therefore it is not written by jesus or god so it is mans words.

John 8 months, 4 weeks ago

I understand your somewhat popular, non-Christian, view.

eileen10 9 months ago

John, well spoken and I agree. I will now bow out because it's the best thing to do. It never does any good to go back and forth on the Bible because no one wins and besides..it's not necessary. Same goes for politics and a host of everything you can think of.

FussyOno 9 months ago

If Paul had in any way seen another value to circumsion he would have stated it. As he said: "For bodily exercise profiteth little: but godliness is profitable unto all things, having promise of the life that now is, and of that which is to come." He said nothing about the value of circumsion. All you have is bogus medical opinions to support circumsion. And there are plenty in opposition. "And if any man shall take away from the words of the book of this prophecy, God shall take away his part out of the book of life, and out of the holy city, and from the things which are written in this book." I have hardly taken from the words of the book, by quoting exact context. Paul said circumsion is unnecessary, and it is. It is you who presumes by reading between the lines. Perhaps you are a misguided OB/GYN.

wayneman11 9 months ago

You, FussyOno, are a hypocrit! Instead of just stating your views/opinions, you want to argue because you think your interpretation of the bible is the only one, (what about all the other religions in the world that interpret the bible differently?). You have no tolerance for other peoples views, which is one reason the world is in the shape it's in! You should just agree to disagree without having to argue. You, no doubt, will take offense and write some kind of scathing retort instead of just excepting the fact that everyone has their personal opinion and views and even though it does not coincide with yours, does not make it wrong. A quote I think should be followed is; "The purpose of an argument/discussion should not be victory, but progress"!

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