After years of taking a neutral stand on whether circumcision should be performed on male newborns, the American Academy of Pediatrics on Monday issued a strong statement saying there are too few medical benefits to justify recommending the procedure.
The academy said its review of medical data suggests that circumcision is not necessary, but added that families should continue to follow personal preferences, including religious traditions. The statement, published in the journal Pediatrics, should help parents who base their decision about circumcision strictly on health criteria.
"Circumcision is not essential to a child's well-being at birth, even though it does have some potential medical benefits," said Dr. Carole Lannon, chairwoman of the academy's task force on circumcision. "These benefits are not compelling enough to warrant the AAP to recommend routine newborn circumcision."
The academy also departed from previous statements by recommending that all newborns undergoing circumcision receive pain relief. The decision to use analgesics during circumcision varies widely nationwide.
The task force based its summary on a review of 40 years of studies, many of which show that the procedure offers some health advantages. Compared to uncircumcised boys, circumcised babies are less likely to develop a urinary tract infection during the first year of life. In addition, the rate of penile cancer is three times lower in circumcised men.
But the academy noted that both penile cancer and infant urinary tract infections have become so rare that parents should not feel it necessary to reduce their child's risk through circumcision.
"It's three- to tenfold more likely for someone uncircumcised to have a urinary tract infection in the first year of life. But it's still rare," said Dr. Alan R. Fleischman, a task force member and senior vice president of the New York Academy of Medicine.
"The benefit is small enough that families shouldn't be criticized for not circumcising their little boy."
The risk of penile cancer also is rare: Only about 10 cases per 1 million men are diagnosed each year in the United States.
The task force addressed concerns that uncircumcised men may be at greater risk for sexually transmitted diseases. It concluded that behavioral factors, such as using condoms, are far more important in determining a person's risk.
