In its first new policy statement since 1999 on the contentious issue, the American Academy of Pediatrics says the procedure’s medical benefits outweigh the risks.
The American Academy of Pediatrics has shifted its official position on the contentious issue of infant circumcision, stating Monday that the medical benefits of the procedure for baby boys outweigh the small risks.
In its first new policy statement on the issue since 1999, the academy said that circumcision reduced risks of urinary tract infections in infants and of HIV and other sexually transmitted diseases later in life — and that the complications associated with the procedure were infrequent and mostly minor.
But the physicians’ group stopped short of recommending the sometimes controversial practice for all newborn boys, urging parents to be guided by their religious, ethical and cultural practices in addition to the science.
“This is a decision parents should make based on what they think is most important for their child’s welfare,” said Dr. Douglas Diekema, a pediatric emergency specialist and bioethicist at Seattle Children’s Hospital who was a member of the task force. “The [medical] benefit may not be so compelling when it’s stacked up against other considerations.”
The academy reexamines its policies on a regular basis, Diekema said. In 2005, it reaffirmed the 1999 guidelines, which acknowledged some potential health benefits of removing the foreskin of the penis but said that they did not outweigh risks.
But during the most recent review it became “pretty clear that there had been a lot of scientific literature that had not been reflected in 1999, and it was time for a revision,” he said.
The task force spent more than three years examining 1,031 peer-reviewed articles published between 1995 and 2010. The studies dealt with various aspects of male circumcision, including medical benefits, risks and complications; costs; cultural and religious influences; and effects on sexual function.
Some of the evidence hadn’t changed much since the earlier analysis, Diekema said, including results indicating that risks associated with infant circumcision were low.
But new data supporting the medical benefits were compelling, he added.
Three randomized controlled trials from Africa, for example, showed that circumcision reduced men’s risk of contracting HIV, the virus that causes AIDS. Additional research supported those findings.