I took a little hiatus over the summer break, so I have no idea if I lost all the wonderful posters -- both pro and anti-circumcision -- during that time. Most of the medical news over the last few months continues to support the benefit of a foreskin-free society, both to protect the health of the male and the health of his partners.
But the most worrisome report, trumped up or not, was this notion that circumcision rates have dropped to one-third of male newborns in the USA. Now the statistics have been debunked by many as way off -- and in this part of the world, nobody I talk to thinks that the circ rate is anything below 80% -- but any drop at all is troubling as a matter of public health.
I've heard that the theory that a lot of these uncircumcised future disease-promoters are illegal aliens from south of the border. It's true that many Hispanics do not circumcise until they become "Americanized" in the second or third generation. It's bad enough that illegals are sneaking into the country -- it's even worse if they are refusing to raise clean-cut boys.
The other theory I've heard is that the refusal of 16 states, including California, to cover circumcision under Medicaid (health care for the poor) has contributed to the growing number of uncircumcised boys. That would particularly hurt the Black community, along with Hispanics, and the refusal to cover circumcisions for these groups is obviously a form of racism.
Whatever the reason for any drop, this makes it all the more urgent for the Centers for Disease Control and the American Academy of Pediatrics to release their 2010 statements calling for the circumcision of all boys. The so-called "neutral" stance of the CDC and the AAP is causing great long-term damage, and we need that more positive statement right now.
Most parents want to do what is right for their sons. If the CDC and the AAP said that circumcision was an appropriate and healthy procedure with a great many benefits, I know that the circ rate -- assuming it even is dropping -- will return to historic high levels of 90%-plus. A foreskin-free America and the health of both males and females is in the balance.
Showing posts with label American Academy of Pediatrics. Show all posts
Showing posts with label American Academy of Pediatrics. Show all posts
Saturday, September 4, 2010
Friday, May 7, 2010
US Pediatrician Group Okays "Minor Circumcision" of Girls
Anti-circumcision fanatics have long argued that if female circumcision is outlawed, then male circumcision should be, too. Of course, this argument assumes that both types of circumcision are the same -- which they are clearly not.
Female circumcision has never been proven to offer any health advantage to the circumcised girl. It is solely a cultural tradition embraced by many around the world. In contrast, in one medical study after another, male circumcision offers positive benefits to the male and his partners. That should end the discussion, but it never does with the anti-circs.
Sure to complicate the debate is an apparent position change by the American Academy of Pediatrics in support of a "nick" or "minor circumcision" of a girl, as a means by which to discourage a full-scale removal of female genital parts. The New York Times below reports the story, and I invite your comments.
While I find female circumcision abhorrent as a practice because it has no medical benefits, I recognize the cultural myopia that we Americans have on this issue. Maybe the AAP is right. If a nick or little cutting makes parents feel comfortable that they do not need to remove the clitoris, labia, or whatever else is involved in full female circumcision, I suppose it is an option that should be considered carefully -- without American cultural blinders affecting our vision.
One thing is certain. The anti-circumcision fanatics will try to use this debate over female circumcision to denounce the obviously beneficial removal of the foreskin from males. Watch my words. I guarantee it.
NewYorkTimes: Group Backs Ritual ‘Nick’ as Female Circumcision Option
By PAM BELLUCK
Published: May 6, 2010
"In a controversial change to a longstanding policy concerning the practice of female circumcision in some African and Asian cultures, the American Academy of Pediatrics is suggesting that American doctors be given permission to perform a ceremonial pinprick or “nick” on girls from these cultures if it would keep their families from sending them overseas for the full circumcision."
"The academy’s committee on bioethics, in a policy statement last week, said some pediatricians had suggested that current federal law, which “makes criminal any nonmedical procedure performed on the genitals” of a girl in the United States, has had the unintended consequence of driving some families to take their daughters to other countries to undergo mutilation."
“It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm,” the group said.
Female circumcision has never been proven to offer any health advantage to the circumcised girl. It is solely a cultural tradition embraced by many around the world. In contrast, in one medical study after another, male circumcision offers positive benefits to the male and his partners. That should end the discussion, but it never does with the anti-circs.
Sure to complicate the debate is an apparent position change by the American Academy of Pediatrics in support of a "nick" or "minor circumcision" of a girl, as a means by which to discourage a full-scale removal of female genital parts. The New York Times below reports the story, and I invite your comments.
While I find female circumcision abhorrent as a practice because it has no medical benefits, I recognize the cultural myopia that we Americans have on this issue. Maybe the AAP is right. If a nick or little cutting makes parents feel comfortable that they do not need to remove the clitoris, labia, or whatever else is involved in full female circumcision, I suppose it is an option that should be considered carefully -- without American cultural blinders affecting our vision.
One thing is certain. The anti-circumcision fanatics will try to use this debate over female circumcision to denounce the obviously beneficial removal of the foreskin from males. Watch my words. I guarantee it.
NewYorkTimes: Group Backs Ritual ‘Nick’ as Female Circumcision Option
By PAM BELLUCK
Published: May 6, 2010
"In a controversial change to a longstanding policy concerning the practice of female circumcision in some African and Asian cultures, the American Academy of Pediatrics is suggesting that American doctors be given permission to perform a ceremonial pinprick or “nick” on girls from these cultures if it would keep their families from sending them overseas for the full circumcision."
"The academy’s committee on bioethics, in a policy statement last week, said some pediatricians had suggested that current federal law, which “makes criminal any nonmedical procedure performed on the genitals” of a girl in the United States, has had the unintended consequence of driving some families to take their daughters to other countries to undergo mutilation."
“It might be more effective if federal and state laws enabled pediatricians to reach out to families by offering a ritual nick as a possible compromise to avoid greater harm,” the group said.
Sunday, March 14, 2010
Newborn Circumcision: An Old Tried & True Friend
I like old books, so take me to a flea market and I am sure to find something that interests me. Not long ago, I bought for an original red-covered book for $1 entitled "Modern Home Medical Adviser." It was first published in 1935 but updated seven times until its last publication in 1953, still way long before I was born. The book was designed for parents to consult on just about any ailment in the body. Of course, I looked in the index under "circumcision" and it was a treasure trove of good advice.
I don't know how popular newborn circumcision was back in the 1930s, but these docs sure liked it. "The baby boy should be carefully examined to see if he needs circumcision. If the foreskin can be completely and easily retracted most authorities think circumcision should not be done, but when there is the least doubt about the matter decision should be made in favor of the operation, which is a trivial one when done within the first week or two of life."
Back in the 1930s, people did worry more about boys masturbating. These docs were modern. "Masturbation is probably far less harmful than has been supposed." But they certainly didn't recommend it, and observed the obvious: "When the foreskin is tight or adherent there will accumulate under it secretions which will produce bad odors and cause pain and itching. Such a child is likely to get into the ugly habit of pulling at and handling the genitals." We know that all boys play with their penises, but uncircumcised boys clearly have more reasons for doing that than clean-cut boys.
While the medical reasons for circumcision have certainly grown with the advance of medical science, back in the 1930s there were many more uncircumcised fathers in America and many more parents in general who did not have access to the latest medical developments. This is where the authors of "Modern Home Medical Adviser" get interesting, urging parents of the day to get informed about the latest medical advances and to take responsibility for their children's health.
"It is said that in times of old, parents had the power of life and death over their childrend and could make away with them or sell them into slavery. Atrocious! Nevertheless, parents still have the power of life and death over their children. Parents can neglect their young, and frequently do neglect them, so that they die of the results. We have in mind parents who are probably ruining a child by refusing to have him circumcised. . . . ."
Seventy-five years later, we still have parents who not only refuse to circumcise their sons but also make outrageous claims about the 'dangers' of circumcision and the 'benefits' of a foreskin. I find this all very ironic because the prescient doctors of the 1930s did not have all the medical studies of today. But they knew circumcision was valuable and recommended it. Today, with much more evidence of this "trivial" procedure's medical value, the medical organizations representing today's doctors (like the American Academy of Pediatrics and the Centers for Disease Control) are much more timid than their ancestors.
As we await some definitive conclusions from the AAP and the CDC, perhaps they might consult the docs of an earlier era -- and add a little backbone to taking a strong stand for newborn circumcision. Just saying . . . .
I don't know how popular newborn circumcision was back in the 1930s, but these docs sure liked it. "The baby boy should be carefully examined to see if he needs circumcision. If the foreskin can be completely and easily retracted most authorities think circumcision should not be done, but when there is the least doubt about the matter decision should be made in favor of the operation, which is a trivial one when done within the first week or two of life."
Back in the 1930s, people did worry more about boys masturbating. These docs were modern. "Masturbation is probably far less harmful than has been supposed." But they certainly didn't recommend it, and observed the obvious: "When the foreskin is tight or adherent there will accumulate under it secretions which will produce bad odors and cause pain and itching. Such a child is likely to get into the ugly habit of pulling at and handling the genitals." We know that all boys play with their penises, but uncircumcised boys clearly have more reasons for doing that than clean-cut boys.
While the medical reasons for circumcision have certainly grown with the advance of medical science, back in the 1930s there were many more uncircumcised fathers in America and many more parents in general who did not have access to the latest medical developments. This is where the authors of "Modern Home Medical Adviser" get interesting, urging parents of the day to get informed about the latest medical advances and to take responsibility for their children's health.
"It is said that in times of old, parents had the power of life and death over their childrend and could make away with them or sell them into slavery. Atrocious! Nevertheless, parents still have the power of life and death over their children. Parents can neglect their young, and frequently do neglect them, so that they die of the results. We have in mind parents who are probably ruining a child by refusing to have him circumcised. . . . ."
Seventy-five years later, we still have parents who not only refuse to circumcise their sons but also make outrageous claims about the 'dangers' of circumcision and the 'benefits' of a foreskin. I find this all very ironic because the prescient doctors of the 1930s did not have all the medical studies of today. But they knew circumcision was valuable and recommended it. Today, with much more evidence of this "trivial" procedure's medical value, the medical organizations representing today's doctors (like the American Academy of Pediatrics and the Centers for Disease Control) are much more timid than their ancestors.
As we await some definitive conclusions from the AAP and the CDC, perhaps they might consult the docs of an earlier era -- and add a little backbone to taking a strong stand for newborn circumcision. Just saying . . . .
Tuesday, January 5, 2010
New Calls for AAP to Embrace Newborn Circumcision
What a terrific way to begin 2010 that to see medical doctors call on the American Academy of Pediatrics to replace its so-called "neutral" policy on newborn male circumcision with an affirmative statement on the clear benefits of this procedure to the male, his partners, and society as a whole.
That's the focus of an article and editorial in the January 2010 issue of the Archives of Pediatric and Adolescent Medicine. Here are some excerpts from Fran Lowry's story in Medscape Medical News:
“During the past 4 years, substantial new data have been published on the health benefits of circumcision,” write Aaron A. R. Tobian, MD, from Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues. “While the historical evidence strongly suggests that male circumcision reduces urinary tract infections and penile inflammatory disorders in infants, we reviewed the more recent evidence with regard to effects on sexually transmitted infections (STIs) in adulthood.”
"To evaluate the effect of circumcision on HIV prevention, the researchers analyzed 3 randomized controlled trials of more than 10,000 men from South Africa, Kenya, and Uganda.
The trials enrolled HIV-negative men to circumcision on enrollment or after 21 to 24 months, and all 3 trials demonstrated that male circumcision significantly decreased male heterosexual HIV acquisition by 53% to 60%, despite differences in age eligibility criteria, urban or rural settings, and surgical procedure.
"Because of this new evidence, the World Health Organization (WHO), together with the Joint United Nations Program on HIV/AIDS (UNAIDS), recommended that male circumcision be provided as an important intervention to reduce heterosexually acquired HIV in men, the study authors report.
"The trials also found that male circumcision decreased herpes simplex virus type 2 (HSV-2) acquisition by 28% to 34% and the prevalence of human papillomavirus (HPV) by 32% to 35% in men.
"Among female partners of circumcised men, bacterial vaginosis was reduced by 40% and Trichomonas vaginalis infection was reduced by 48%, the study authors write.
"The study authors note that the rates of neonatal circumcision complications are between 0.2% and 0.6% of operations performed. The most common complications are bleeding and local infection, which are controlled with pressure and wound care or antibiotics. Other complications, such as phimosis and concealed penis, adhesions, fistula, meatitis, meatal stenosis, and injury to the glans, are extremely rare.
"They add that there was no evidence of change in sexual behavior after circumcision in the African randomized controlled trials. “Thus, there are risks to neonatal circumcision, but serious long-term complications are extremely rare,” the study authors write.
“The rare short-term risks of neonatal circumcision need to be weighed against the potential benefits accrued in infancy and childhood (eg, reduction of urinary tract infections), the longer-term benefits that may accrue in adolescence and adulthood (eg, reduced risks of HIV, HSV-2, and HPV), as well as possible benefits to female sexual partners of circumcised men (eg, reduced bacterial vaginosis and trichomonas),” Dr. Tobian and colleagues write.
"Medicaid does not cover the cost of male circumcision in 16 states, and the lack of coverage particularly affects disadvantaged minorities, who have the highest risk for HIV and sexually transmitted diseases. “These socioeconomically disadvantaged groups could benefit most if Medicaid covered the costs of neonatal circumcision. Thus, the AAP’s policy has important implications for the health of disadvantaged minorities,” they write.
"They conclude that it is time for the AAP policy to fully reflect current data.
"In an accompanying editorial, Michael T. Brady, MD, from Nationwide Children’s Hospital in Columbus, Ohio, writes that the study authors have provided a very objective review of the available data. Although the 3 randomized trials were performed in Africa, “it is clear that circumcision does offer health benefits, even in the United States,” he notes.
"The current evidence on the health benefits of circumcision is adequate enough to include circumcision in medical coverage provided by Medicaid or commercial insurance providers, Dr. Brady points out. “This is particularly relevant since over the past decade many state Medicaid programs have discontinued payment for circumcision.”
That's the focus of an article and editorial in the January 2010 issue of the Archives of Pediatric and Adolescent Medicine. Here are some excerpts from Fran Lowry's story in Medscape Medical News:
“During the past 4 years, substantial new data have been published on the health benefits of circumcision,” write Aaron A. R. Tobian, MD, from Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues. “While the historical evidence strongly suggests that male circumcision reduces urinary tract infections and penile inflammatory disorders in infants, we reviewed the more recent evidence with regard to effects on sexually transmitted infections (STIs) in adulthood.”
"To evaluate the effect of circumcision on HIV prevention, the researchers analyzed 3 randomized controlled trials of more than 10,000 men from South Africa, Kenya, and Uganda.
The trials enrolled HIV-negative men to circumcision on enrollment or after 21 to 24 months, and all 3 trials demonstrated that male circumcision significantly decreased male heterosexual HIV acquisition by 53% to 60%, despite differences in age eligibility criteria, urban or rural settings, and surgical procedure.
"Because of this new evidence, the World Health Organization (WHO), together with the Joint United Nations Program on HIV/AIDS (UNAIDS), recommended that male circumcision be provided as an important intervention to reduce heterosexually acquired HIV in men, the study authors report.
"The trials also found that male circumcision decreased herpes simplex virus type 2 (HSV-2) acquisition by 28% to 34% and the prevalence of human papillomavirus (HPV) by 32% to 35% in men.
"Among female partners of circumcised men, bacterial vaginosis was reduced by 40% and Trichomonas vaginalis infection was reduced by 48%, the study authors write.
"The study authors note that the rates of neonatal circumcision complications are between 0.2% and 0.6% of operations performed. The most common complications are bleeding and local infection, which are controlled with pressure and wound care or antibiotics. Other complications, such as phimosis and concealed penis, adhesions, fistula, meatitis, meatal stenosis, and injury to the glans, are extremely rare.
"They add that there was no evidence of change in sexual behavior after circumcision in the African randomized controlled trials. “Thus, there are risks to neonatal circumcision, but serious long-term complications are extremely rare,” the study authors write.
“The rare short-term risks of neonatal circumcision need to be weighed against the potential benefits accrued in infancy and childhood (eg, reduction of urinary tract infections), the longer-term benefits that may accrue in adolescence and adulthood (eg, reduced risks of HIV, HSV-2, and HPV), as well as possible benefits to female sexual partners of circumcised men (eg, reduced bacterial vaginosis and trichomonas),” Dr. Tobian and colleagues write.
"Medicaid does not cover the cost of male circumcision in 16 states, and the lack of coverage particularly affects disadvantaged minorities, who have the highest risk for HIV and sexually transmitted diseases. “These socioeconomically disadvantaged groups could benefit most if Medicaid covered the costs of neonatal circumcision. Thus, the AAP’s policy has important implications for the health of disadvantaged minorities,” they write.
"They conclude that it is time for the AAP policy to fully reflect current data.
"In an accompanying editorial, Michael T. Brady, MD, from Nationwide Children’s Hospital in Columbus, Ohio, writes that the study authors have provided a very objective review of the available data. Although the 3 randomized trials were performed in Africa, “it is clear that circumcision does offer health benefits, even in the United States,” he notes.
"The current evidence on the health benefits of circumcision is adequate enough to include circumcision in medical coverage provided by Medicaid or commercial insurance providers, Dr. Brady points out. “This is particularly relevant since over the past decade many state Medicaid programs have discontinued payment for circumcision.”
Tuesday, December 29, 2009
Feast of the Circumcision
Happy New Year!
This new year -- 2010 -- promises to be one of the best ever for advocates of a foreskin-free world. The medical evidence continues to grow on the health benefits conferred by circumcision, and 2010 will bring even more studies by reputable scientists and world health organizations to validate the life-long advantages of early circumcision.
Led by strong government policies in many countries, some nations especially in Africa will move closer to the goal of 100% circumcision, thereby reducing the threat of HIV, STDs, HPV, cancer, and all sorts of other deadly ailments. In the USA, we expect the Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) to resist the hyperbolic pressure of the anti-circumcision fanatics by embracing a clear health-based call for the circumcision of all male newborns. Of course, they will insist that it's "voluntary" but the message will be clear: circumcision confers clear health benefits for the male, his sexual partners, and society as a whole.
The year 2010 will also see an uptick in the number of American males who are circumcised. The message has gotten through to parents via a generally positive US media that most anti-circs are shrill, beligerant, penis obsessed nuts who want to deny parents the right to care for their children in the most medically responsible way. Moreover, the average American knows that it's better to be circumcised than not.
Finally, for centuries the Christian church celebrated January 1st as the Feast of the Circumcision, the day Jesus was circumcised in accordance with the traditions of the time. The "good news" today is that, all over the world, circumcision has become the tradition of the 21st century. Whether a church embraces the date or not, we should bring back the Feast of the Circumcision on New Years Day, a way to honor the scientists, the doctors, and the parents who have made circumcision as popular as it is. May 2010 be the year that circumcision is embraced by all. Happy New Year!
This new year -- 2010 -- promises to be one of the best ever for advocates of a foreskin-free world. The medical evidence continues to grow on the health benefits conferred by circumcision, and 2010 will bring even more studies by reputable scientists and world health organizations to validate the life-long advantages of early circumcision.
Led by strong government policies in many countries, some nations especially in Africa will move closer to the goal of 100% circumcision, thereby reducing the threat of HIV, STDs, HPV, cancer, and all sorts of other deadly ailments. In the USA, we expect the Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) to resist the hyperbolic pressure of the anti-circumcision fanatics by embracing a clear health-based call for the circumcision of all male newborns. Of course, they will insist that it's "voluntary" but the message will be clear: circumcision confers clear health benefits for the male, his sexual partners, and society as a whole.
The year 2010 will also see an uptick in the number of American males who are circumcised. The message has gotten through to parents via a generally positive US media that most anti-circs are shrill, beligerant, penis obsessed nuts who want to deny parents the right to care for their children in the most medically responsible way. Moreover, the average American knows that it's better to be circumcised than not.
Finally, for centuries the Christian church celebrated January 1st as the Feast of the Circumcision, the day Jesus was circumcised in accordance with the traditions of the time. The "good news" today is that, all over the world, circumcision has become the tradition of the 21st century. Whether a church embraces the date or not, we should bring back the Feast of the Circumcision on New Years Day, a way to honor the scientists, the doctors, and the parents who have made circumcision as popular as it is. May 2010 be the year that circumcision is embraced by all. Happy New Year!
Thursday, November 26, 2009
Circumcision -- A Reason to Give Thanks on Thanksgiving
On this Thanksgiving Day in America -- I know Canada celebrates it earlier and I don't know about other countries -- I am grateful for circumcision, a very minor procedure that has a major impact on the health of so many.
I am thankful I live in a country where the right of every parent to circumcise is both maintained and encouraged. It is true that a very very small minority of fanatics is trying to take that right away, but freedom to raise your children in a healthy way is inherent in American values. As long as parents are guaranteed those rights, circumcision will be as American as the pumpkin pie we eat today. Every baby boy has the right to be circumcised, clean-cut, and disease-free, and I give thanks that America will always be a circumcised country.
I am thankful for all the US doctors who work hard to produce the scientific studies that support universal circumcision. I am thankful for the Centers for Disease Control and the American Academy of Pediatrics for resisting the absurd claims of foreskin lovers. I hope both the CDC and AAP can resist political pressure from these few and declare, once and for all, that every male should be circumcised.
I am thankful for all of you -- whether pro or anti-circ -- for engaging in this debate in a positive manner. I hope this blog has been a positive contribution to the ongoing debate. As long as you enjoy it and use it, I'll keep posting.
Happy Thanksgiving!
I am thankful I live in a country where the right of every parent to circumcise is both maintained and encouraged. It is true that a very very small minority of fanatics is trying to take that right away, but freedom to raise your children in a healthy way is inherent in American values. As long as parents are guaranteed those rights, circumcision will be as American as the pumpkin pie we eat today. Every baby boy has the right to be circumcised, clean-cut, and disease-free, and I give thanks that America will always be a circumcised country.
I am thankful for all the US doctors who work hard to produce the scientific studies that support universal circumcision. I am thankful for the Centers for Disease Control and the American Academy of Pediatrics for resisting the absurd claims of foreskin lovers. I hope both the CDC and AAP can resist political pressure from these few and declare, once and for all, that every male should be circumcised.
I am thankful for all of you -- whether pro or anti-circ -- for engaging in this debate in a positive manner. I hope this blog has been a positive contribution to the ongoing debate. As long as you enjoy it and use it, I'll keep posting.
Happy Thanksgiving!
Thursday, November 5, 2009
New Study: Circumcision Reduces Herpes & HPV in Males
How long must we wait for the Centers for Disease Control and the American Academy of Pediatrics to take account of the growing body of medical evidence that points in only one direction -- every boy should be circumcised to protect himself, his partners, and society as a whole.
This week, still another study in the New England Journal of Medicine confirms that male circumcision reduces a male's chance of getting genital herpes and HPV.
After years of such evidence, it's amazing that the CDC and AAP feel so threatened by a small group of anti-circumcision fanatics that they appear to be back-pedaling on doing what is medically right. I will never understand why the foreskin fetishists go to such extremes, but eventually even the docs at the CDC and AAP will yield to medical science and declare what most of us know is true: circumcision is good for every boy!
For more evidence of that, read the full Reuters story, as reported in the Vancouver Times Colonist:
Circumcision protects men from genital herpes and a virus that causes genital warts and cancer but it does not appear to guard against syphilis, U.S. and Ugandan researchers said on Wednesday.
The report in the New England Journal of Medicine adds to the debate over whether men — and newborn boys — should be circumcised to protect their health and perhaps the health of their future sexual partners.
The findings from two trials in Uganda build on related research showing that circumcision cuts a man's risk of HIV infection through heterosexual intercourse by more than 50 per cent, said Anthony Fauci of the National Institutes of Health in the United States, which funded the study.
They also come at a time when circumcision rates are declining in places like the United States even as evidence mounts that the practice can provide important health benefits.
"Medically supervised adult male circumcision is a scientifically proven method for reducing a man's risk of acquiring HIV infection through heterosexual intercourse," he said.
"This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well."
The human papillomavirus, or HPV, is the most common sexually transmitted infection in the world. It causes cervical cancer, which kills 300,000 women globally every year.
The team, which also included researchers from Johns Hopkins University in the United States and Makerere University in Uganda, conducted two parallel clinical trials to analyse the impact of male circumcision as a public health tool.
The combined results of the studies looking at more than 3,000 men showed circumcision reduced the risk of herpes by 25 per cent and of HPV by one third. HPV also causes anal and penile cancers.
Circumcision also appeared to reduce the odds of genital warts but had no effect on the incidence of syphilis, the researchers added.
The study highlights the potential of using circumcision to protect people most at risk of the infections in the developing world, especially Africa, where HIV and HPV are widespread.
"Efforts to scale-up male circumcision could have tremendous benefit," said David Serwadda of Makerere University in Uganda, who worked on the study.
Since 2007, circumcision has been promoted by the World Health Organization and the United Nations Program on HIV/AIDS as a way to reduce the risk of AIDS in areas where heterosexual transmission is high.
When done in children, the operation reduces the chance of urinary tract infections and phimosis, a problem with the foreskin.
This week, still another study in the New England Journal of Medicine confirms that male circumcision reduces a male's chance of getting genital herpes and HPV.
After years of such evidence, it's amazing that the CDC and AAP feel so threatened by a small group of anti-circumcision fanatics that they appear to be back-pedaling on doing what is medically right. I will never understand why the foreskin fetishists go to such extremes, but eventually even the docs at the CDC and AAP will yield to medical science and declare what most of us know is true: circumcision is good for every boy!
For more evidence of that, read the full Reuters story, as reported in the Vancouver Times Colonist:
Circumcision protects men from genital herpes and a virus that causes genital warts and cancer but it does not appear to guard against syphilis, U.S. and Ugandan researchers said on Wednesday.
The report in the New England Journal of Medicine adds to the debate over whether men — and newborn boys — should be circumcised to protect their health and perhaps the health of their future sexual partners.
The findings from two trials in Uganda build on related research showing that circumcision cuts a man's risk of HIV infection through heterosexual intercourse by more than 50 per cent, said Anthony Fauci of the National Institutes of Health in the United States, which funded the study.
They also come at a time when circumcision rates are declining in places like the United States even as evidence mounts that the practice can provide important health benefits.
"Medically supervised adult male circumcision is a scientifically proven method for reducing a man's risk of acquiring HIV infection through heterosexual intercourse," he said.
"This new research provides compelling evidence that circumcision can provide some protection against genital herpes and human papillomavirus infections as well."
The human papillomavirus, or HPV, is the most common sexually transmitted infection in the world. It causes cervical cancer, which kills 300,000 women globally every year.
The team, which also included researchers from Johns Hopkins University in the United States and Makerere University in Uganda, conducted two parallel clinical trials to analyse the impact of male circumcision as a public health tool.
The combined results of the studies looking at more than 3,000 men showed circumcision reduced the risk of herpes by 25 per cent and of HPV by one third. HPV also causes anal and penile cancers.
Circumcision also appeared to reduce the odds of genital warts but had no effect on the incidence of syphilis, the researchers added.
The study highlights the potential of using circumcision to protect people most at risk of the infections in the developing world, especially Africa, where HIV and HPV are widespread.
"Efforts to scale-up male circumcision could have tremendous benefit," said David Serwadda of Makerere University in Uganda, who worked on the study.
Since 2007, circumcision has been promoted by the World Health Organization and the United Nations Program on HIV/AIDS as a way to reduce the risk of AIDS in areas where heterosexual transmission is high.
When done in children, the operation reduces the chance of urinary tract infections and phimosis, a problem with the foreskin.
Friday, October 16, 2009
Anti Circumcision Radicals to Protest AAP Docs
You want to know why so many people dismiss the ravings of the anti circumcision fanatics? Just read their latest press release, announcing their intent to demonstrate at this weekend's conference of the American Academy of Pediatrics.
"Intactivists will be protesting what they believe to be an unethical and sexist practice—infant circumcision—at the American Academy of Pediatrics National Conference and Exhibition (AAP NCE, 2009), Washington Convention Center, Washington, DC, October 17-20. . . . Intactivist Dan Strandjord, Chicago, says, “Cutting off the end of a boy’s penis is not what a medical “hero” should do. It is a "villainous" practice, there is no medical reason for it. . . . Demonstrators will be carrying placards satirizing the conference’s cartoon characters of pediatricians as flying super-heroes. It depicts a super-hero protecting a baby boy with the comment: “Real heroes don’t cut babies.” Girls are protected from genital cutting, even a pinprick, by federal law, but boys have no protection. Circumcision is a multi-million dollar income stream for doctors, a source of revenue that is almost doubled in order to repair poorly performed circumcisions."
Well, it will be interesting to see what kind of national news coverage these antics get. The media generally ignores the couple dozen nutcases who show up for their annual penis walk on the U.S. Capitol.
It's pretty much a waste of time to rebut all the lies in this typical anti-circ press release. Circumcision is hardly "villainous" because there are so many medical reasons to do it. And the typical foreskin lover tactic of equating female genital mutilation with male circumcision is getting rather boring. As for docs making money off circs, at $50 or $100 a clip, it's not exactly a money winner.
So let the fanatics march on. It only makes their "cause" seem sillier and sillier.
"Intactivists will be protesting what they believe to be an unethical and sexist practice—infant circumcision—at the American Academy of Pediatrics National Conference and Exhibition (AAP NCE, 2009), Washington Convention Center, Washington, DC, October 17-20. . . . Intactivist Dan Strandjord, Chicago, says, “Cutting off the end of a boy’s penis is not what a medical “hero” should do. It is a "villainous" practice, there is no medical reason for it. . . . Demonstrators will be carrying placards satirizing the conference’s cartoon characters of pediatricians as flying super-heroes. It depicts a super-hero protecting a baby boy with the comment: “Real heroes don’t cut babies.” Girls are protected from genital cutting, even a pinprick, by federal law, but boys have no protection. Circumcision is a multi-million dollar income stream for doctors, a source of revenue that is almost doubled in order to repair poorly performed circumcisions."
Well, it will be interesting to see what kind of national news coverage these antics get. The media generally ignores the couple dozen nutcases who show up for their annual penis walk on the U.S. Capitol.
It's pretty much a waste of time to rebut all the lies in this typical anti-circ press release. Circumcision is hardly "villainous" because there are so many medical reasons to do it. And the typical foreskin lover tactic of equating female genital mutilation with male circumcision is getting rather boring. As for docs making money off circs, at $50 or $100 a clip, it's not exactly a money winner.
So let the fanatics march on. It only makes their "cause" seem sillier and sillier.
Saturday, September 26, 2009
Operation Abraham Coming to USA
Three cheers for Dr. Inon Schenker! A couple weeks ago, Ha'aretz News, an Israeli paper, published a story about Dr. Schenker and something called Operation Abraham. The good doctor was at the recent CDC meeting in Atlanta and proposed bringing his Operation Abraham to America. As described in the newspaper, "Operation Abraham [is] a group of Israeli doctors who gained expertise in circumcision by performing the procedure thousands of times, quickly and safely, on Russian-Jewish men who were raised outside Jewish tradition and immigrated to Israel in the 1990s. "
Knowing that America has a growing foreskin problem, not only because too many boys are left uncircumcised, but also because our fast growing immigrant population is largely foreskin afflicted, Dr. Schenker suggests: "Why not bring mass adult male circumcision to the Hispanic and African-American communities of America?" Indeed, to all Americans, I would add, because we have many whites and asians here who still are at risk to themselves and their partners because of their uncircumcised status.
Operation Abraham is not something new and novel. The altruistic doctor and his team have already perfected it in African countries. Here's what Ha'aretz reported: "The resulting abstract, which Dr. Schenker presented in Atlanta, proposes to help train American doctors in much the same way as was effective in Swaziland: by working side by side and showing them how to circumcise efficiently. The innovation creates what Schenker called an "assembly line" technique, working in a team, using only local anesthesia and perfecting a "clamp" method of foreskin removal that uses forceps. The Israeli doctors boast that they are able to perform 30 or 40 circumcisions a day."
The link between HIV, STDs, HPV, cancer, and all sorts of other pernicious diseases and the foreskin is now conclusive. Operation Abraham is a humanitarian effort to save the lives of millions of uncircumcised Americans who, through no fault of their own, were not circumcised at birth like most Americans.
So far, the U.S. government has not embraced Dr. Schenker's proposal. They should do so immediately. After all, U.S. taxpayers spend millions to circumcise Africans. Why not spend a little of that money on our own people? Readers of my blog know that I think it is hypocritical for us to circumcise the rest of the world and ignore our own. Dr. Schenker is offering a great public service.
The Ha'aretz article notes that some of the anti-circumcision foreskin lovers are trying to portray the Israeli docs as some sort of proselytizers for Judaism. That strikes me as anti-semitic. No, these docs are not mohels. No, they are not looking for Jewish converts. But, yes, they want to help restore America to its clean-cut status of the 1960s & 1970s. After all the money and support America has given Israel over the decades, I can't think of a better way for Israel to return the favor than to let its docs eliminate the foreskin from our continent.
Obviously, the expected recommendation from the Centers for Disease Control and the American Academy of Pediatrics that all newborn boys be circumcised will help in the future, but Operation Abraham could be just what the doctor ordered for American males who were not so fortunate at birth. Dr. Schenker, we need you and want you!
Knowing that America has a growing foreskin problem, not only because too many boys are left uncircumcised, but also because our fast growing immigrant population is largely foreskin afflicted, Dr. Schenker suggests: "Why not bring mass adult male circumcision to the Hispanic and African-American communities of America?" Indeed, to all Americans, I would add, because we have many whites and asians here who still are at risk to themselves and their partners because of their uncircumcised status.
Operation Abraham is not something new and novel. The altruistic doctor and his team have already perfected it in African countries. Here's what Ha'aretz reported: "The resulting abstract, which Dr. Schenker presented in Atlanta, proposes to help train American doctors in much the same way as was effective in Swaziland: by working side by side and showing them how to circumcise efficiently. The innovation creates what Schenker called an "assembly line" technique, working in a team, using only local anesthesia and perfecting a "clamp" method of foreskin removal that uses forceps. The Israeli doctors boast that they are able to perform 30 or 40 circumcisions a day."
The link between HIV, STDs, HPV, cancer, and all sorts of other pernicious diseases and the foreskin is now conclusive. Operation Abraham is a humanitarian effort to save the lives of millions of uncircumcised Americans who, through no fault of their own, were not circumcised at birth like most Americans.
So far, the U.S. government has not embraced Dr. Schenker's proposal. They should do so immediately. After all, U.S. taxpayers spend millions to circumcise Africans. Why not spend a little of that money on our own people? Readers of my blog know that I think it is hypocritical for us to circumcise the rest of the world and ignore our own. Dr. Schenker is offering a great public service.
The Ha'aretz article notes that some of the anti-circumcision foreskin lovers are trying to portray the Israeli docs as some sort of proselytizers for Judaism. That strikes me as anti-semitic. No, these docs are not mohels. No, they are not looking for Jewish converts. But, yes, they want to help restore America to its clean-cut status of the 1960s & 1970s. After all the money and support America has given Israel over the decades, I can't think of a better way for Israel to return the favor than to let its docs eliminate the foreskin from our continent.
Obviously, the expected recommendation from the Centers for Disease Control and the American Academy of Pediatrics that all newborn boys be circumcised will help in the future, but Operation Abraham could be just what the doctor ordered for American males who were not so fortunate at birth. Dr. Schenker, we need you and want you!
Monday, September 7, 2009
1954 Time Magazine Article Promotes Universal Circumcision
Sometimes the old ways of doing things make the most sense, even if the reasons for doing them advance with medical science. That's what came to mind as I read this 1954 article in an April 5 issue of Time Magazine. Entitled "Medicine: Circumcision & Cancer," the weekly news magazine, which I'm told (before my time) influenced a few generations of American parents, reinforced the growing belief among the parents of Babyboomers in the USA that a clean-cut penis was the only penis to have.
I'm going to reprint the article with my comments in bold italics. Enjoy.
"The fact that 85% of the boy babies born in U.S. private hospitals nowadays are circumcised, regardless of the parents' religious beliefs, may be an important factor in reducing cancer of the uterine cervix (neck of the womb) in years to come. Dr. Ernest L. Wynder. of Manhattan's Memorial Center for Cancer and Allied Diseases, has reached this comforting conclusion after studying the striking differences in the incidence of cervical cancer among women with different marital histories."
So by 1954, 85% of American boys were clean cut. That number probably grew to 95% ten years later. America had become, even 55 years ago, a circumcised nation. And reinforcing a mother's view that her son should be clean-cut is this report that a male's circumcision reduces cervical cancer in a woman.
"It all began with the oft-quoted observation that among Jewish women whose husbands have been routinely, ritually circumcised, cervical cancer is only one-tenth to one-fifth as common as among non-Jewish women of similar age and social status. Was this coincidence or what? To find out, Dr. Wynder arranged exhaustive interviews of 1,900 women in twelve U.S. hospitals scattered over four states; one-third of them had cervical cancer, while the rest (the controls) had other diseases of the pelvis."
"The answers ruled out the possibility of coincidence. They also ruled out pregnancy and number of pregnancies, abortions, miscarriages and douches as possible causes of this type of cancer (which, in frequency, is second only to breast cancer among U.S. women, and takes an estimated 14,000 lives a year, despite thousands of operations for removal).
Looks like Dr. Wynder knew what he was doing here, using lots of women (1,900) in four states. I suspect the anti-circ fanatics (and, fortunately, there were not any at the time) would have found something to complain about.
"Dr. Wynder's key findings:
¶ A woman whose husband is uncircumcised runs 2½ times as great a risk of cervical cancer as a woman, married only once, whose husband has been circumcised.
¶ A woman married only once, but beginning intercourse at 16, is twice as likely to develop cervical cancer as a woman married between 20 and 24. The likelihood keeps going down as the marriage age goes up.
¶ A woman who has two or more marital partners runs a proportionately greater risk of cervical cancer than those married once.
Note that circumcision is not the only factor Dr. Wynder found in the reduced rate of cervical cancer in women. Multiple husbands and early intercourse can increase the rates. But a woman whose husband has a foreskin is 2-1/2 times more likely to get cervical cancer than the woman with a clean-cut circumcised husband. Given that women so often call the shots about whether their son is circumcised, this kind of medical evidence must have been very persuasive indeed.
"That marriage and sexual relations are not the only elements in cervical cancer was shown by the fact that 1% of the victims had never had intercourse. To test his U.S. findings, Dr. Wynder enlisted the help of physicians in India and found direct confirmation: cervical cancer is far commoner among the wives of uncircumcised Hindus than among those of circumcised Moslems, though their hygienic standards are about the same. "
Again, even though cleanliness was the same among both, the wives of uncircumcised Hindus were at greater risk for cancer than circumcised Muslims. No surprise there. In fact, it matches the earlier observation about lower cervical cancer rates among Jewish women.
"Among men, penile cancer is far rarer than cervical cancer among women, but its occurrence follows the same pattern. Dr. Wynder's deduction: circumcision may be a big help in preventing both, presumably because it facilitates personal cleanliness."
When Time Magazine calls circumcision "a big help" back in 1954, you know that American parents were listening. Today, with so much more medical evidence in support of newborn circumcision because it reduces the risk of STDs, HIV, HPV, cancer, and the like, you have to wonder why the Centers for Disease Control and the American Academy of Pediatrics are being so slow to embrace what their parents and grandparents embraced 55 years ago. Except for a few fanatics with loud voices, the vast majority of American parents want to keep America a clean circumcised nation. We knew it in 1954 -- and we know it in 2009!
I'm going to reprint the article with my comments in bold italics. Enjoy.
Medicine: Circumcision & Cancer
TIME: April 5, 1954
"The fact that 85% of the boy babies born in U.S. private hospitals nowadays are circumcised, regardless of the parents' religious beliefs, may be an important factor in reducing cancer of the uterine cervix (neck of the womb) in years to come. Dr. Ernest L. Wynder. of Manhattan's Memorial Center for Cancer and Allied Diseases, has reached this comforting conclusion after studying the striking differences in the incidence of cervical cancer among women with different marital histories."
So by 1954, 85% of American boys were clean cut. That number probably grew to 95% ten years later. America had become, even 55 years ago, a circumcised nation. And reinforcing a mother's view that her son should be clean-cut is this report that a male's circumcision reduces cervical cancer in a woman.
"It all began with the oft-quoted observation that among Jewish women whose husbands have been routinely, ritually circumcised, cervical cancer is only one-tenth to one-fifth as common as among non-Jewish women of similar age and social status. Was this coincidence or what? To find out, Dr. Wynder arranged exhaustive interviews of 1,900 women in twelve U.S. hospitals scattered over four states; one-third of them had cervical cancer, while the rest (the controls) had other diseases of the pelvis."
"The answers ruled out the possibility of coincidence. They also ruled out pregnancy and number of pregnancies, abortions, miscarriages and douches as possible causes of this type of cancer (which, in frequency, is second only to breast cancer among U.S. women, and takes an estimated 14,000 lives a year, despite thousands of operations for removal).
Looks like Dr. Wynder knew what he was doing here, using lots of women (1,900) in four states. I suspect the anti-circ fanatics (and, fortunately, there were not any at the time) would have found something to complain about.
"Dr. Wynder's key findings:
¶ A woman whose husband is uncircumcised runs 2½ times as great a risk of cervical cancer as a woman, married only once, whose husband has been circumcised.
¶ A woman married only once, but beginning intercourse at 16, is twice as likely to develop cervical cancer as a woman married between 20 and 24. The likelihood keeps going down as the marriage age goes up.
¶ A woman who has two or more marital partners runs a proportionately greater risk of cervical cancer than those married once.
Note that circumcision is not the only factor Dr. Wynder found in the reduced rate of cervical cancer in women. Multiple husbands and early intercourse can increase the rates. But a woman whose husband has a foreskin is 2-1/2 times more likely to get cervical cancer than the woman with a clean-cut circumcised husband. Given that women so often call the shots about whether their son is circumcised, this kind of medical evidence must have been very persuasive indeed.
"That marriage and sexual relations are not the only elements in cervical cancer was shown by the fact that 1% of the victims had never had intercourse. To test his U.S. findings, Dr. Wynder enlisted the help of physicians in India and found direct confirmation: cervical cancer is far commoner among the wives of uncircumcised Hindus than among those of circumcised Moslems, though their hygienic standards are about the same. "
Again, even though cleanliness was the same among both, the wives of uncircumcised Hindus were at greater risk for cancer than circumcised Muslims. No surprise there. In fact, it matches the earlier observation about lower cervical cancer rates among Jewish women.
"Among men, penile cancer is far rarer than cervical cancer among women, but its occurrence follows the same pattern. Dr. Wynder's deduction: circumcision may be a big help in preventing both, presumably because it facilitates personal cleanliness."
When Time Magazine calls circumcision "a big help" back in 1954, you know that American parents were listening. Today, with so much more medical evidence in support of newborn circumcision because it reduces the risk of STDs, HIV, HPV, cancer, and the like, you have to wonder why the Centers for Disease Control and the American Academy of Pediatrics are being so slow to embrace what their parents and grandparents embraced 55 years ago. Except for a few fanatics with loud voices, the vast majority of American parents want to keep America a clean circumcised nation. We knew it in 1954 -- and we know it in 2009!
Sunday, August 23, 2009
US Health Officials Closer to Pushing Universal Circumcision
Good news out of the NY Times today. The US Centers for Disease Control (CDC) appears closer than ever to recommending that every male in America be circumcised, preferably at birth. This, of course, is the logical outcome of all the studies over the last decade that demonstrate conclusively that circumcision has a positive health benefit on not only the circumcised male but also his partners and society as a whole.
The story published this Sunday quotes Dr. Peter Kilmarx, the CDC's chief of epidemiology, as saying, "What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.” The CDC is expected to make its recommendation public by the end of the year, although anti-circ foreskin lovers are waging an all-out effort to save the foreskin through a misleading campaign of lies and innuendoes.
The Times reporter also notes that "circumcision will be discussed this week at the C.D.C.’s National H.I.V. Prevention Conference in Atlanta, which will be attended by thousands of health professionals and H.I.V. service providers."
The United States was once a truly clean-cut country but circumcision rates have fallen because the American Academy of Pediatrics abandoned its pro-circ position in favor of "neutrality." That caused some insurance companies and state Medicaid programs to abandon payment for newborn circumcision.
But as the Times reporter noted, "The academy is revising its guidelines, however, and is likely to do away with the neutral tone in favor of a more encouraging policy stating that circumcision has health benefits even beyond H.I.V. prevention, like reducing urinary tract infections for baby boys, said Dr. Michael Brady, a consultant to the American Academy of Pediatrics."
"He said the academy would probably stop short of recommending routine surgery, however. 'We do have evidence to suggest there are health benefits, and families should be given an opportunity to know what they are,' he said."
Curiously, it's the CDC that is taking the lead to return America to a fully circumcised clean-cut status, while the AAP -- if Dr. Brady is correct -- seems more reluctant to just say what most baby docs know is true: a clean circumcised penis is the healthy choice.
You can read the full NY Times article at http://www.nytimes.com/2009/08/24/health/policy/24circumcision.html?hp
The story published this Sunday quotes Dr. Peter Kilmarx, the CDC's chief of epidemiology, as saying, "What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.” The CDC is expected to make its recommendation public by the end of the year, although anti-circ foreskin lovers are waging an all-out effort to save the foreskin through a misleading campaign of lies and innuendoes.
The Times reporter also notes that "circumcision will be discussed this week at the C.D.C.’s National H.I.V. Prevention Conference in Atlanta, which will be attended by thousands of health professionals and H.I.V. service providers."
The United States was once a truly clean-cut country but circumcision rates have fallen because the American Academy of Pediatrics abandoned its pro-circ position in favor of "neutrality." That caused some insurance companies and state Medicaid programs to abandon payment for newborn circumcision.
But as the Times reporter noted, "The academy is revising its guidelines, however, and is likely to do away with the neutral tone in favor of a more encouraging policy stating that circumcision has health benefits even beyond H.I.V. prevention, like reducing urinary tract infections for baby boys, said Dr. Michael Brady, a consultant to the American Academy of Pediatrics."
"He said the academy would probably stop short of recommending routine surgery, however. 'We do have evidence to suggest there are health benefits, and families should be given an opportunity to know what they are,' he said."
Curiously, it's the CDC that is taking the lead to return America to a fully circumcised clean-cut status, while the AAP -- if Dr. Brady is correct -- seems more reluctant to just say what most baby docs know is true: a clean circumcised penis is the healthy choice.
You can read the full NY Times article at http://www.nytimes.com/2009/08/24/health/policy/24circumcision.html?hp
Saturday, August 1, 2009
Zambia Goal: 80% Circumcised
You have to admire some of the health ministers and governments in Africa that understand the health value of circumcision -- and, more importantly, are not afraid to set goals aimed at universal male circumcision.
The latest word from Zambia, reported in The Post, is that the country's health minister has embraced circumcision as an important HIV prevention strategy. Moreover, the World Health Organization's representative in Zambia, Dr. Olusegun Babaniyi, has said the country must achieve an 80% circumcision rate in 10 years to maximize the effectiveness of circumcision. The current rate is about 13% circumcised. This would require about 2.5 million males to be circumcised.
Of course, the most effective way to achieve universal circumcision is neonatal circumcision. Circumcising at birth is easier, less complicated, and much less costly. University Teaching Hospital urologist Dr. Kasonde Bowa says his hospital has begun a neonatal circumcision pilot program, but admits they have a long ways to go.
Taking a country that is only 13% circumcised up to 80% circumcised and, preferably, 100% circumcised takes a time and dedication. Countries like Zambia deserve world acclaim -- and our help -- to achieve their goal of a clean foreskin-free environment.
Here in the United States, where perhaps 75% to 85% of males are clean-cut, we need stronger government advocates for circumcision. The anti-circ fanatics are reportedly putting intense political pressure on the Centers for Disease Control and the American Academy of Pediatrics to ignore all the medical studies of recent years. Whether America's doctors cave in to political pressure when the medical evidence is so abundant remains to be seen. But there's no question that those who recognize the health benefits to both men and women of a clean-cut foreskin-free society need to speak up -- now!
The latest word from Zambia, reported in The Post, is that the country's health minister has embraced circumcision as an important HIV prevention strategy. Moreover, the World Health Organization's representative in Zambia, Dr. Olusegun Babaniyi, has said the country must achieve an 80% circumcision rate in 10 years to maximize the effectiveness of circumcision. The current rate is about 13% circumcised. This would require about 2.5 million males to be circumcised.
Of course, the most effective way to achieve universal circumcision is neonatal circumcision. Circumcising at birth is easier, less complicated, and much less costly. University Teaching Hospital urologist Dr. Kasonde Bowa says his hospital has begun a neonatal circumcision pilot program, but admits they have a long ways to go.
Taking a country that is only 13% circumcised up to 80% circumcised and, preferably, 100% circumcised takes a time and dedication. Countries like Zambia deserve world acclaim -- and our help -- to achieve their goal of a clean foreskin-free environment.
Here in the United States, where perhaps 75% to 85% of males are clean-cut, we need stronger government advocates for circumcision. The anti-circ fanatics are reportedly putting intense political pressure on the Centers for Disease Control and the American Academy of Pediatrics to ignore all the medical studies of recent years. Whether America's doctors cave in to political pressure when the medical evidence is so abundant remains to be seen. But there's no question that those who recognize the health benefits to both men and women of a clean-cut foreskin-free society need to speak up -- now!
Tuesday, July 7, 2009
Failure to Circumcise Cost Millions of Deaths
Sometimes it takes awhile for medical scientists to understand the importance of the discoveries made by fellow researchers. Such was the case of the link between the foreskin and HIV/AIDs, a discovery first made nearly 25 years ago.
Alex Renton, a reporter for The Observer, wrote this over the weekend:
"In 1985 researchers discovered that circumcised men who visited prostitutes in Kenya were much less likely to contract HIV. Some 30 studies on the issue were done during the 1990s, but it was not until 2004 that formal double-blind trials were commissioned by international Aids agencies. As a result of "overwhelming results" from these, pilot programmes for mass circumcision of men began in a number of African countries late last year. "
"It is now accepted by the World Health Organisation and other bodies that circumcision reduces chances of HIV infection by about 60%, and that up to 3 million deaths and 5.7 million infections could be prevented over the next 20 years. About 30 million people are thought to have died from Aids-related illnesses since 1981."
Dr Catherine Hankins, the chief scientific adviser to UNAids, the United Nations special agency for the epidemic, said that the failure to test the findings in the 1990s was "hard to explain".
"There's a good question to be asked of the research agencies: why they did not start the trials earlier," said Hankins. "We had 20 years of observational data on circumcision. I can't think of another product, or a technique, that waited for so long before trials." Circumcision has now been proved a very cost-effective way of reducing the rate of HIV infection, she said.
"Professor Francis Plummer, who led the University of Nairobi research team that first discovered the circumcision-HIV link in Kenya in the 1980s, said millions of lives might have been saved if his research had been acted upon sooner.
"There's been a failure of global public health institutions. We haven't done it very well. It's a frustration I've lived with for a very long time," Plummer said.
The failure of public health organizations to act has been deadly, not just in Africa but all over the world. In 2009, there is absolutely no reason for any male to have a disease-causing filthy foreskin. How long must we wait until the American Academy of Pediatrics and the U.S. Centers for Disease Control, to say nothing of their counterparts in other countries, wake up? It's time for the AAP and CDC to state clearly: the circumcision of every boy is a must to protect not only their own health, but also the health of their partners and society as a whole.
Alex Renton, a reporter for The Observer, wrote this over the weekend:
"In 1985 researchers discovered that circumcised men who visited prostitutes in Kenya were much less likely to contract HIV. Some 30 studies on the issue were done during the 1990s, but it was not until 2004 that formal double-blind trials were commissioned by international Aids agencies. As a result of "overwhelming results" from these, pilot programmes for mass circumcision of men began in a number of African countries late last year. "
"It is now accepted by the World Health Organisation and other bodies that circumcision reduces chances of HIV infection by about 60%, and that up to 3 million deaths and 5.7 million infections could be prevented over the next 20 years. About 30 million people are thought to have died from Aids-related illnesses since 1981."
Dr Catherine Hankins, the chief scientific adviser to UNAids, the United Nations special agency for the epidemic, said that the failure to test the findings in the 1990s was "hard to explain".
"There's a good question to be asked of the research agencies: why they did not start the trials earlier," said Hankins. "We had 20 years of observational data on circumcision. I can't think of another product, or a technique, that waited for so long before trials." Circumcision has now been proved a very cost-effective way of reducing the rate of HIV infection, she said.
"Professor Francis Plummer, who led the University of Nairobi research team that first discovered the circumcision-HIV link in Kenya in the 1980s, said millions of lives might have been saved if his research had been acted upon sooner.
"There's been a failure of global public health institutions. We haven't done it very well. It's a frustration I've lived with for a very long time," Plummer said.
The failure of public health organizations to act has been deadly, not just in Africa but all over the world. In 2009, there is absolutely no reason for any male to have a disease-causing filthy foreskin. How long must we wait until the American Academy of Pediatrics and the U.S. Centers for Disease Control, to say nothing of their counterparts in other countries, wake up? It's time for the AAP and CDC to state clearly: the circumcision of every boy is a must to protect not only their own health, but also the health of their partners and society as a whole.
Tuesday, June 30, 2009
Happy 4th of July: Circumcision as American as Apple Pie
Happy Fourth of July, blog readers! As we celebrate America's independence for over 200 years, it's also a good time to celebrate our freedom of choice to circumcise our sons in the traditional American way.
Circumcision is as American as apple pie. "We are a circumcised country," one pediatrician was quoted as saying. The roots of the practice are very old and very deep in this country, perhaps not back to the Founding Fathers but at least 150 years old.
Today, to be uncircumcised is to be un-American, not in the political context, but in the social context. That's why so many second generation Americans from all over the world circumcise their sons -- "to be American" -- is the common refrain. This accepted belief, that you're not really a true American if you're uncircumcised, drives the anti-circ fanatics ballistic. But it's deeply engrained in the fabric of our country.
I would argue that circumcision unites us. We may come from different religious, ethnic, and national backgrounds -- but one thing almost all American boys share is a circumcised penis. It may strike uncircumcised foreigners as whacky, but it's the one thing (hopefully along with our common language) that American males can share together.
Admittedly, circumcision is not as universal here as it is in the Phillipines or Korea. The Filipino government offers free circumcisions to encourage a foreskin-free nation, while some of our states have withdrawn free Medicaid coverage of circumcision. This will likely change when the Centers for Disease Control and the American Academy of Pediatrics update their policies to encourage circumcision as an effective HIV, STD, HPV prophylactic.
In the meantime, on this Fourth of July, let's celebrate our circumcised nation and our freedom to circumcise our sons, something the anti-circs are working hard to deny us. They won't succeed because America is and will always be a circumcised country.
Happy Fourth of July!
Circumcision is as American as apple pie. "We are a circumcised country," one pediatrician was quoted as saying. The roots of the practice are very old and very deep in this country, perhaps not back to the Founding Fathers but at least 150 years old.
Today, to be uncircumcised is to be un-American, not in the political context, but in the social context. That's why so many second generation Americans from all over the world circumcise their sons -- "to be American" -- is the common refrain. This accepted belief, that you're not really a true American if you're uncircumcised, drives the anti-circ fanatics ballistic. But it's deeply engrained in the fabric of our country.
I would argue that circumcision unites us. We may come from different religious, ethnic, and national backgrounds -- but one thing almost all American boys share is a circumcised penis. It may strike uncircumcised foreigners as whacky, but it's the one thing (hopefully along with our common language) that American males can share together.
Admittedly, circumcision is not as universal here as it is in the Phillipines or Korea. The Filipino government offers free circumcisions to encourage a foreskin-free nation, while some of our states have withdrawn free Medicaid coverage of circumcision. This will likely change when the Centers for Disease Control and the American Academy of Pediatrics update their policies to encourage circumcision as an effective HIV, STD, HPV prophylactic.
In the meantime, on this Fourth of July, let's celebrate our circumcised nation and our freedom to circumcise our sons, something the anti-circs are working hard to deny us. They won't succeed because America is and will always be a circumcised country.
Happy Fourth of July!
Saturday, April 25, 2009
American Academy of Pediatrics Statement on Circumcision We Hope to See
Somewhere circulating within the emails of the American Academy of Pediatrics' Task Force on Circumcision, there is a draft proposal updating the AAP's 1999 "neutral" stance on circumcision in light of the growing medical evidence in favor of male circumcision. You can call this a fictional wish-list, but we hope the AAP has the guts to issue a report something like this:
After a comprehensive review of the latest medical and scientific evidence, the American Academy of Pediatrics concludes that all males should be circumcised, preferably at birth, as a matter of both personal medical well-being and general public health to protect themselves, their future sexual partners, and society as a whole from a number of debilitating, life-threatening, and costly diseases.
In 1999, the AAP declared that “scientific evidence demonstrates potential medical benefits of newborn male circumcision,” but we cautioned that “these data are not sufficient to recommend routine neonatal circumcision.” This position, reaffirmed in 2005, understandably left parents of newborn males in a quandary. While the medical benefits of circumcision were established, such as a substantial reduction in urinary tract infection, the evidence was not then compelling to recommend that every male be circumcised. Parents were left to draw their own conclusions, which meant that social, familial, and other non-medical concerns often took priority over health care in the decision-making process.
With substantial new scientific evidence over the last four years, the AAP now recommends that all newborn males be circumcised, and we encourage all public and private health insurers and medical providers to cover, promote, and establish efficacious ways to achieve universal male circumcision. We endorse routine neonatal circumcision, with all the appropriate analgesics to alleviate pain, and we recommend that all males, regardless of age, be circumcised. Circumcision not only confers life-long benefits on the male, but it also protects his female partners and society as a whole.
Among its other benefits, circumcision reduces a male’s chance of acquiring HIV by at least 50 percent, reduces his risk of acquiring HPV by 35 percent and spreading HPV to his female partners, reduces his chances of contracting Herpes Simplex Virus Type II by 28 percent, and reduces the likelihood of causing cervical cancer in his female partners. The AAP does not assert that circumcision eliminates these painful and costly medical scourges, but it will significantly reduce them. These health benefits to males and females far outweigh any risks posed by circumcision, and to suggest otherwise is to engage in a head-in-the-sand approach to science for political and non-medical reasons.
We recognize that the decision to circumcise children lies with the parent, so, consequently, just as with AAP-recommended vaccinations, an option not to circumcise must be made available. But the AAP concludes that sound science dictates the goal of universal male circumcision, regardless of the race, nationality, religion, age, or economic status of the male. A requirement by schools that all boys be circumcised before puberty is recommended, subject to exception for religious or deeply-held objection, or a rare medical necessity. But like the eradication of polio and measles through a policy of universal vaccination, the public health benefits of circumcision are best conferred when adopted by all.
This position in no way impugns the decision of many parents in recent years that left their sons uncircumcised. The decision not to circumcise was perfectly understandable, particularly in the context of the AAP’s former position. But medical science advances, and health care requirements must change with that evidence. Boys left uncircumcised, particularly as they become sexually active, increase their own risks and those with whom they are intimate. That is why the AAP encourages both public and private health insurers and health providers to establish cost-effective options to circumcise both young and older males. And we encourage parents of uncircumcised boys to take advantage of those options as quickly as possible.
Finally, we believe that the evidence for universal male circumcision is so compelling that the United States Government, through the Surgeon General, the Public Health Service, the Centers for Disease Control, Centers for Medicare & Medicaid Services, and all other relevant agencies, needs to engage in a public information campaign and improve affordable access to circumcision for all American males of every age. Under the leadership of the World Health Organization, many other governments have taken such a pro-active lead. The American Academy of Pediatrics urges the U.S. Government to do the same. A country with the greatest medical scientists, practitioners, and institutions should once again take the lead on this critical public health mission.
"DRAFT DRAFT DRAFT"
Task Force on Circumcision
American Academy of Pediatrics
Benefits of Male Circumcision Outweigh Risks
A Call to Universal Circumcision
Executive Summary
After a comprehensive review of the latest medical and scientific evidence, the American Academy of Pediatrics concludes that all males should be circumcised, preferably at birth, as a matter of both personal medical well-being and general public health to protect themselves, their future sexual partners, and society as a whole from a number of debilitating, life-threatening, and costly diseases.
In 1999, the AAP declared that “scientific evidence demonstrates potential medical benefits of newborn male circumcision,” but we cautioned that “these data are not sufficient to recommend routine neonatal circumcision.” This position, reaffirmed in 2005, understandably left parents of newborn males in a quandary. While the medical benefits of circumcision were established, such as a substantial reduction in urinary tract infection, the evidence was not then compelling to recommend that every male be circumcised. Parents were left to draw their own conclusions, which meant that social, familial, and other non-medical concerns often took priority over health care in the decision-making process.
With substantial new scientific evidence over the last four years, the AAP now recommends that all newborn males be circumcised, and we encourage all public and private health insurers and medical providers to cover, promote, and establish efficacious ways to achieve universal male circumcision. We endorse routine neonatal circumcision, with all the appropriate analgesics to alleviate pain, and we recommend that all males, regardless of age, be circumcised. Circumcision not only confers life-long benefits on the male, but it also protects his female partners and society as a whole.
Among its other benefits, circumcision reduces a male’s chance of acquiring HIV by at least 50 percent, reduces his risk of acquiring HPV by 35 percent and spreading HPV to his female partners, reduces his chances of contracting Herpes Simplex Virus Type II by 28 percent, and reduces the likelihood of causing cervical cancer in his female partners. The AAP does not assert that circumcision eliminates these painful and costly medical scourges, but it will significantly reduce them. These health benefits to males and females far outweigh any risks posed by circumcision, and to suggest otherwise is to engage in a head-in-the-sand approach to science for political and non-medical reasons.
We recognize that the decision to circumcise children lies with the parent, so, consequently, just as with AAP-recommended vaccinations, an option not to circumcise must be made available. But the AAP concludes that sound science dictates the goal of universal male circumcision, regardless of the race, nationality, religion, age, or economic status of the male. A requirement by schools that all boys be circumcised before puberty is recommended, subject to exception for religious or deeply-held objection, or a rare medical necessity. But like the eradication of polio and measles through a policy of universal vaccination, the public health benefits of circumcision are best conferred when adopted by all.
This position in no way impugns the decision of many parents in recent years that left their sons uncircumcised. The decision not to circumcise was perfectly understandable, particularly in the context of the AAP’s former position. But medical science advances, and health care requirements must change with that evidence. Boys left uncircumcised, particularly as they become sexually active, increase their own risks and those with whom they are intimate. That is why the AAP encourages both public and private health insurers and health providers to establish cost-effective options to circumcise both young and older males. And we encourage parents of uncircumcised boys to take advantage of those options as quickly as possible.
Finally, we believe that the evidence for universal male circumcision is so compelling that the United States Government, through the Surgeon General, the Public Health Service, the Centers for Disease Control, Centers for Medicare & Medicaid Services, and all other relevant agencies, needs to engage in a public information campaign and improve affordable access to circumcision for all American males of every age. Under the leadership of the World Health Organization, many other governments have taken such a pro-active lead. The American Academy of Pediatrics urges the U.S. Government to do the same. A country with the greatest medical scientists, practitioners, and institutions should once again take the lead on this critical public health mission.
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