Circumcision: US experts review current advice
22 January 2010
US paediatricians are reviewing whether to change their position and advocate circumcision for newborn boys as the evidence of benefits linked to the procedure grows.
The findings from 3 randomised trials published since 2005 have provided the impetus for professional bodies such as the American Academy of Pediatrics to revise recommendations, experts wrote in a leading journal (Arch Ped Adol Med 2010; 164: 78-84).
The 3 trials found that circumcision reduced the rate of males getting certain infections, including human immunodeficiency virus (HIV), herpes simplex virus type 2 (which causes genital herpes), and human papillomavirus (which causes genital warts). HIV acquisition was reduced by at least 53 per cent, herpes simplex virus type 2 (HSV-2) acquisition was reduced by at least 28 per cent, and human papillomavirus (HPV) prevalence was reduced by 32 per cent in men, they said.
In addition, one study found female partners of circumcised men were 40 per cent less likely to have bacterial vaginosis (a condition involving an imbalance of bacteria in the vagina and overgrowth of certain harmful bacteria).
However, a group of Australian surgeons is less convinced of the benefits. Their systematic review of 8 randomised controlled trials concluded that while there was evidence that circumcision did reduce HIV/AIDS acquisition among sub-Saharan African men, this could not be generalised to other populations (Ann Fam Med 2010; 8: 64-72).
“Current evidence fails to recommend widespread neonatal circumcision” for the prevention of STIs (sexually transmitted infections), UTIs (urinary tract infections) and penile cancer, they said.
In August 2009 the Royal Australasian College of Physicians updated its position on circumcision, saying the decision was one parents should be able to make in consultation with their doctor. A further review is currently underway.
Last Reviewed: 22 January 2010
- 1. Tobian AA, Gray RH, Quinn TC. Male circumcision for the prevention of acquisition and transmission of sexually transmitted infections: the case for neonatal circumcision. Arch Pediatr Adolesc Med 2010; 164: 78-84
2. Perera CL, Bridgewater FH, Thavaneswaren P, Maddern GJ. Safety and efficacy of nontherapeutic male circumcision: a systematic review. Ann Fam Med 2010; 8: 64-72
