Once upon a time, boys in Australia were as clean-cut as their American cousins. Then the national nannies stepped in to discourage and not pay for this important neonatal procedure. But even during the "bad times" a number of Australian parents opted to circumcise their sons. Now, the growing evidence of the medical benefits of circumcision are reaching parents, despite the reluctance of some in the Australian medical bureaucracy.
Under the headline -- "More boys go under knife as parents opt for kind cut" -- the Sydney Morning Herald reports a resurgence in newborn circumcision in New South Wales. It's still a long ways from American standards, but the good news is that trend is upward. One doctor predicts it will grow quickly to 30% over the next decade.
The headline is also a sign of the change in times. After some used to call circumcision "an unkind cut," how refreshing to see this simple health-giving procedure call what it is: a "kind cut" -- in fact, it's the kindest cut of all a parent can do for a newborn baby boy.
Here's the full story below:
CIRCUMCISION is making a comeback as a new generation of parents arm themselves with medical research to justify their decision.
The rate of circumcision for baby boys in NSW rose from 13 per cent in 1999 to 18 per cent last year, according to Medicare figures.
It's a long way from the 1950s when boys were routinely circumcised but Sydney paediatric surgeon Dr Anthony Dilley predicts the rate will keep rising. This is despite NSW Health banning circumcisions from public hospitals in 2006, except in cases of medical emergency.
"By the time today's baby boys are in kindergarten, it will be 30 per cent," Dr Dilley said.
Dr Dilley said parents were asking for circumcision because they thought it would benefit their child – "to look like dad", be more hygienic and reduce risk of disease – rather than for cultural or religious reasons."My own gut feeling is that there are parents who didn't get it done 20 or 30 years ago because they were bullied out of it," Dr Dilley said. "Most parents now don't stand for being told: 'Don't do it.' They will do their own research."
Proponents of circumcision such as Professor Brian Morris from the University of Sydney school of medical sciences say it is a kind of "surgical vaccine", pointing to studies showing it reduces the incidence of urinary tract infections, sexually transmitted diseases, penile cancer and penile inflammatory disorders, as well as being more hygienic.
It has also been shown to reduce the incidence of cervical cancer in female partners.
"At birth it's a very simple, safe procedure that gives immediate benefit through infancy and continues through life," he said.
The Royal Australian College of Physicians recently softened its opposition towards circumcision. Its 2004 position statement said there was no medical indication for routine neonatal circumcision and that benefits needed to be weighed against a complication rate of 1 to 5 per cent but its interim statement released last year was more nuanced, saying parental choice should be respected.
The college's paediatric and child health policy committee chairman Professor David Forbes said: "We have stepped back and said: 'Yes, there are ethical issues around circumcision but ultimately we have to have a policy that fits with society's practice and acknowledging parents' role in the decision-making process, while recognising the potential benefits and risks'."
But the statement recommends parents should wait until their boys are old enough to make their own decision on circumcision – the subject of a petition by pro-circumcision clinicians led by Professor Morris, who say infancy is best for the procedure.
Royal Australian College of General Practitioners national spokesman Dr Ronald McCoy said he didn't believe there was any reason to circumcise except for a handful of medical indications but agreed the debate was not going away.
"It certainly is a real issue. Parents want to find out what's best for their kids," Dr McCoy said.
General Practice NSW chairman Dr Ken Mackey said circumcision was generally safe but there were still slight risks of infection or deformity of the penis. "As always, fully informed consent is important," he said.
Showing posts with label Australia. Show all posts
Showing posts with label Australia. Show all posts
Saturday, February 20, 2010
Tuesday, June 9, 2009
Aussie/NZ Doctors Cave to Anti-Circumcision Fanatics
According to The Age, a Melbourne newspaper, the Australia/New Zealand college of physicians is not yet ready to do the obvious -- recommend the circumcision of all baby boys. Anti-circumcision fanatics have been more successful on that continent than in the USA, dropping the number of healthy, clean-cut boys over the last twenty years.
Here's the article from its June 6 paper with my comments in boldface:
"THE Royal Australasian College of Physicians has flagged it will not change its policy against circumcision despite evidence the procedure can prevent the spread of HIV and other sexual diseases." [How much medical evidence do these docs need?]
"The college, which represents physicians and pediatricians in Australia and New Zealand, has adopted the position that "there is no medical indication for routine neonatal circumcision" since 2004." [A bad decision in 2004, but much worse in 2009.]
"But it has been reviewing this stance in part following recent scientific research suggesting that the risk of HIV infection could be dramatically reduced by the practice. Three trials conducted in South Africa, Kenya and Uganda between 2005 and 2007 showed conclusively, according to the World Health Organisation, "that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent". [Repeat, docs, circumcision cuts the risk of HIV by 60% -- what are you waiting for? 100%?].
"Further research, published this year in the New England Journal of Medicine, has found that circumcision can reduce the transfer of human papillomavirus — the chief cause of cervical cancer in women — by 35 per cent, and herpes simplex virus — the chief cause of herpes — by 25 per cent." [So, on top of the HIV reduction, it cuts cervical cancer in women by 35% and herpes by 25%, and you Aussie/NZ docs still won't acknowledge the obvious?]
"The journal said the findings underscored "the potential public health benefits of the procedure". The college, which began its review in 2006 and was supposed to come out with a revised policy at the end of 2007, will not do so until the end of this year, as it considers the new evidence." [Better late than never, but what are you waiting for?]
"It is estimated that 10 to 20 per cent of male infants are circumcised in Australia." [Ewww, the thought of so many filthy foreskins in Australia should make us all sick, especially their future female partners].
"The chairman of the college's panel considering the issue, David Forbes, of the University of Western Australia's school of pediatrics, said the African studies had delayed the new recommendation, but so too had the fact "it is a contentious and non-clear-cut issue". [It's only contentious for the foreskin lovers who won't recognize medical evidence.]
"It's quite clear that there's evidence that circumcision in adult males helps prevent HIV in Africa," said Professor Forbes. "It's not so clear that circumcision in Australia in infants is of benefit to the infants or the community. Policy is about getting the right message to health planners so that we have safe but cost-effective expenditure." [The best time to circumcise is at birth, folks. Safer, cheaper, faster, pain-free, cleaner. Everyone knows that.]
New concerns about the practice of circumcision in Australia were raised last week after the Tasmanian Law Reform Institute found that parental consent might not be enough to protect the circumcisers of baby boys from later legal action. [Another distraction by the foreskin lovers. Since when can parents not consent to life-saving medical procedures for their children?]
No specific laws regulate the removal of the foreskin. [The biggest improvement would be a law to require circumcision before entering school, as a public safety measure like vaccinations.]
Professor Forbes said he wanted to have the college's position "finalised by the end of this year, hopefully before". [Again, better late than never].
"He said the benefit of reducing human papillomavirus "appears not to be such an issue in Australia" because a vaccine was being produced. And there were important differences between the HIV situation in Africa and Australia: HIV rates in Australia were far lower and condom use was much higher." [HIV rates are lower in Australia because the previous generation, now sexually active, were circumcised at birth. With so many young boys now afflicted with a foreskin, those rates will change by 2020].
"He said while there was clear evidence that circumcision reduced the rate of urinary tract infection, this alone did not justify routine use of the procedure as the infection rate was so small.
He said the 10-strong panel consisted of pediatricians, surgeons and policy and public health experts. "There are extremely strong views at both ends of the spectrum for those who promote circumcision and those who oppose it," he said." [Yes, another benefit of circumcision, the reduction of UTI. The list of benefits goes on and on and on, but Aussie docs ignore them].
"Undertaking elective surgery of minors who are not able to consent is for many pediatricians an even bigger issue, especially when there are examples of (Muslim) societies who elect to have it at puberty when people can choose." [This 'consent' issue is another red herring raised by the anti-circ fanatics. What about parental rights and responsibilities to keep their children healthy?]
"Dr Forbes declined to preview what the college's recommendation would be. "Policy change tends to be evolutionary, not revolutionary, and given that there are no trials of neonatal circumcision for prevention of HIV, I wouldn't expect revolutionary change. I would expect evolutionary change." [Just follow the science, dudes].
"Roger Short, from Melbourne University's department of obstetrics and gynaecology, hopes the college will view circumcision in a more favourable light. "It would be exciting to see the Royal College come forward with a slightly more progressive attitude than its previous pronouncements," he said. "The evidence is coming in, and it is irrefutable, that there are major benefits." [Thank you, Dr. Short. You're a doc who speaks the truth on the science].
"Professor Short said there were no grounds for making circumcision mandatory." [Well, I disagree about this. Circumcision should be required for all boys, with exceptions for the obvious conscientious religious objection].
Instead, the college should change its recommendation. "I think we should go from saying 'when in doubt, don't circumcise' to 'when in doubt, do'." [Absolutely. So Aussie/NZ docs, just do it].
Here's the article from its June 6 paper with my comments in boldface:
"THE Royal Australasian College of Physicians has flagged it will not change its policy against circumcision despite evidence the procedure can prevent the spread of HIV and other sexual diseases." [How much medical evidence do these docs need?]
"The college, which represents physicians and pediatricians in Australia and New Zealand, has adopted the position that "there is no medical indication for routine neonatal circumcision" since 2004." [A bad decision in 2004, but much worse in 2009.]
"But it has been reviewing this stance in part following recent scientific research suggesting that the risk of HIV infection could be dramatically reduced by the practice. Three trials conducted in South Africa, Kenya and Uganda between 2005 and 2007 showed conclusively, according to the World Health Organisation, "that male circumcision reduces the risk of heterosexually acquired HIV infection in men by approximately 60 per cent". [Repeat, docs, circumcision cuts the risk of HIV by 60% -- what are you waiting for? 100%?].
"Further research, published this year in the New England Journal of Medicine, has found that circumcision can reduce the transfer of human papillomavirus — the chief cause of cervical cancer in women — by 35 per cent, and herpes simplex virus — the chief cause of herpes — by 25 per cent." [So, on top of the HIV reduction, it cuts cervical cancer in women by 35% and herpes by 25%, and you Aussie/NZ docs still won't acknowledge the obvious?]
"The journal said the findings underscored "the potential public health benefits of the procedure". The college, which began its review in 2006 and was supposed to come out with a revised policy at the end of 2007, will not do so until the end of this year, as it considers the new evidence." [Better late than never, but what are you waiting for?]
"It is estimated that 10 to 20 per cent of male infants are circumcised in Australia." [Ewww, the thought of so many filthy foreskins in Australia should make us all sick, especially their future female partners].
"The chairman of the college's panel considering the issue, David Forbes, of the University of Western Australia's school of pediatrics, said the African studies had delayed the new recommendation, but so too had the fact "it is a contentious and non-clear-cut issue". [It's only contentious for the foreskin lovers who won't recognize medical evidence.]
"It's quite clear that there's evidence that circumcision in adult males helps prevent HIV in Africa," said Professor Forbes. "It's not so clear that circumcision in Australia in infants is of benefit to the infants or the community. Policy is about getting the right message to health planners so that we have safe but cost-effective expenditure." [The best time to circumcise is at birth, folks. Safer, cheaper, faster, pain-free, cleaner. Everyone knows that.]
New concerns about the practice of circumcision in Australia were raised last week after the Tasmanian Law Reform Institute found that parental consent might not be enough to protect the circumcisers of baby boys from later legal action. [Another distraction by the foreskin lovers. Since when can parents not consent to life-saving medical procedures for their children?]
No specific laws regulate the removal of the foreskin. [The biggest improvement would be a law to require circumcision before entering school, as a public safety measure like vaccinations.]
Professor Forbes said he wanted to have the college's position "finalised by the end of this year, hopefully before". [Again, better late than never].
"He said the benefit of reducing human papillomavirus "appears not to be such an issue in Australia" because a vaccine was being produced. And there were important differences between the HIV situation in Africa and Australia: HIV rates in Australia were far lower and condom use was much higher." [HIV rates are lower in Australia because the previous generation, now sexually active, were circumcised at birth. With so many young boys now afflicted with a foreskin, those rates will change by 2020].
"He said while there was clear evidence that circumcision reduced the rate of urinary tract infection, this alone did not justify routine use of the procedure as the infection rate was so small.
He said the 10-strong panel consisted of pediatricians, surgeons and policy and public health experts. "There are extremely strong views at both ends of the spectrum for those who promote circumcision and those who oppose it," he said." [Yes, another benefit of circumcision, the reduction of UTI. The list of benefits goes on and on and on, but Aussie docs ignore them].
"Undertaking elective surgery of minors who are not able to consent is for many pediatricians an even bigger issue, especially when there are examples of (Muslim) societies who elect to have it at puberty when people can choose." [This 'consent' issue is another red herring raised by the anti-circ fanatics. What about parental rights and responsibilities to keep their children healthy?]
"Dr Forbes declined to preview what the college's recommendation would be. "Policy change tends to be evolutionary, not revolutionary, and given that there are no trials of neonatal circumcision for prevention of HIV, I wouldn't expect revolutionary change. I would expect evolutionary change." [Just follow the science, dudes].
"Roger Short, from Melbourne University's department of obstetrics and gynaecology, hopes the college will view circumcision in a more favourable light. "It would be exciting to see the Royal College come forward with a slightly more progressive attitude than its previous pronouncements," he said. "The evidence is coming in, and it is irrefutable, that there are major benefits." [Thank you, Dr. Short. You're a doc who speaks the truth on the science].
"Professor Short said there were no grounds for making circumcision mandatory." [Well, I disagree about this. Circumcision should be required for all boys, with exceptions for the obvious conscientious religious objection].
Instead, the college should change its recommendation. "I think we should go from saying 'when in doubt, don't circumcise' to 'when in doubt, do'." [Absolutely. So Aussie/NZ docs, just do it].
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