Circumcision in the United States: medical and nonmedical attitudes

Abstract

The issue of routine neonatal circumcision has continued to generate debate in the United States in recent years. In 1975, the Ad Hoc Task Force on Circumcision of the American Academy of Pediatrics concluded that there was no absolute medical indication for routine circumcision of the male newborn. This conclusion reconfirmed the findings of the Committee on Fetus and Newborn of the American Academy of Pediatrics in 1971. In the Task Force report, the various traditional arguments for circumcision such as prevention of phimosis, reduction of the incidence of carcinoma of the penis and carcinoma of the cervix, reduction of the incidence of carcinoma of the prostate, and elimination of balanitis were refuted. The 1975 Task Force felt that a program of education leading to continuing good personal hygiene would offer all the advantages of a routine circumcision without the attendant surgical risk. Specifically, proper penile hygiene appeared to be just as effective as circumcision in the prevention of carcinoma of the penis and cervix and in the elimination of balanitis [1]. However, during this same period, Burger and Guthrie presented a strong argument for routine neonatal circumcision shortly before the report of the Task Force [2]. These authors argued in favor of neonatal circumcision for the prevention of balanitis, phimosis and paraphimosis, carcinoma of the penis, and transmission of venereal diseases. In particular, they felt that the incidence of complications was so extremely low that the routine performance of this procedure was justified. These authors also felt that routine neonatal circumcision was reasonable from an economic point of view