New Policy on Circumcision—Cause for Concern

Abstract

* Abbreviations: AAP = : American Academy of Pediatrics • UTI = : urinary tract infection • HIV = : human immunodeficiency virus • STD = : sexually transmitted disease • CIS = : carcinoma in situ The negative conclusions on newborn circumcision drawn by the recent American Academy of Pediatrics (AAP) Task Force on Circumcision are misleading and contrary to the current medical evidence, including data in the body of the report itself1 and in the references cited therein. As professionals closely involved with clinical investigations on newborn circumcision,2–7 we are compelled to express our concern about this report. The Task Force states that newborn circumcision is not recommended and that the procedure is “not essential to the child's current well-being.”1 The media and the public are now understandably convinced that the AAP has adopted an anticircumcision stance compared with its previous neutral position on newborn circumcision.2 This attitude has not only been taken by the activist anticircumcision forces but also by the respected media: eg, “Circumcision Loses a Key Endorsement” ( Washington Post ),8 “Circumcision Benefits Disputed” ( Chicago Sun-Times ),9 “Pediatricians Turn Away From Circumcision” ( CNN ),10 and “Circumcision Opponents Energized by About-Face of Academy of Pediatrics” ( Forward ).11 One would assume that in the decade since the 1989 report,2 new evidence must have appeared demonstrating substantial disadvantage of newborn circumcision. However, the opposite is true. Considerable published data from the past 10 years (much of it cited in the current report) confirm and reinforce previous evidence on the medical benefits of newborn circumcision, particularly in protecting against urinary tract infection (UTI) and human immunodeficiency virus (HIV) infection. Pain—a major disadvantage of the procedure—has been shown to be safely and effectively controlled by local anesthesia. With more proven advantages and fewer disadvantages, how could the Task Force issue a statement that could only be interpreted as reversing previous policy and discouraging newborn circumcision? The report of the 1989 Task Force, for which 1 of the authors (E.J.S.) …