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Pediatric Group Shifts Policy On Circumcision

Ruby de Luna

The issue of infant circumcision has been controversial. For years the American Academy of Pediatrics has remained neutral. It has said there are some health benefits and there are some risks to the procedure. In essence, it has stayed neutral. But as KUOW's Ruby de Luna reports, the Academy recently shifted its position.


The practice of circumcising infant boys used to be routine. But in the last decade or so, it has declined. That's in part because the American Academy of Pediatrics didn't have a strong position about circumcision. For years the group has held that the health benefits weren't enough to justify a recommendation.

Today, the academy is revising its policy.

Diekema: "There are significant medical benefits to circumcision, and those benefits outweigh the risks of circumcision."

Dr. Doug Diekema is a professor of pediatrics at the University of Washington and Seattle Children's Hospital. He was part of the academy's task force that reviewed its circumcision policy.

Diekema says the task force analyzed more than 1,000 journal articles on circumcision. They found that circumcision provided significant health benefits, including reduced risk of urinary tract infection in babies.

Diekema: "That's not as trivial as what many adults think of as a bladder infection. A baby with a urinary tract infection gets hospitalized, gets intravenous antibiotics, and it's a much bigger deal; they could get quite sick."

And in adulthood, Diekema says circumcision reduces the risk for penile cancer. Recent studies also show that it helps reduce HIV and other sexually transmitted diseases.

But not everyone is buying that conclusion.

Dr. George Denniston is a retired family practice doctor. He heads the Group Doctors Opposing Circumcision.

Denniston is critical of the studies the task force used to draw its conclusion. He points to research from Johns Hopkins University that focused on HIV rates among men in Africa. The study found that circumcised men were less likely to get HIV than those who were not.

Denniston: "It has nothing to do anything with America; the studies have nothing to do with any decisions that should be made about circumcision in America."

Denniston says that study is not applicable to the US. Compared to Africa, America's HIV transmission rate is lower.

Dr. Diekema acknowledges there are differences between the two countries. One of them is how the disease is spread. In Africa the disease is transmitted by men having sex with women. In the US it's mostly spread by men having sex with men.

Diekema: "But that doesn't mean it's not important. I think the bottom line is you can take these studies and extrapolate to the United States. It's also not responsible to ignore that data when it may have important health implications."

In light of this recent review, the American Academy of Pediatrics has shifted its position and has concluded that there are health benefits to circumcision. But it's still up to the parents to make that decision. Diekema says this latest review provides new medical information for them to consider.

Dr. Denniston says the academy is simply passing the buck.

Denniston: "Parents do not have the right to do something that could be harmful to their child; that's the current medical ethical standard. Yet in this particular case that's what they're doing. They're doing what we consider to be very harmful to their child."

Beyond the personal decisions, the academy's revised position may have financial implications. The group recommends insurance reimbursement for the procedure.

I'm Ruby de Luna, KUOW News.

© Copyright 2012, KUOW