title: Cultural bias in the AAP's 2012 Technical Report and Policy Statement on male circumcision.
abstract: The American Academy of Pediatrics recently released its new Technical Report and Policy Statement on male circumcision, concluding that current evidence indicates that the health benefits of newborn male circumcision outweigh the risks. The technical report is based on the scrutiny of a large number of complex scientific articles. Therefore, while striving for objectivity, the conclusions drawn by the 8 task force members reflect what these individual physicians perceived as trustworthy evidence. Seen from the outside, cultural bias reflecting the normality of nontherapeutic male circumcision in the United States seems obvious, and the report's conclusions are different from those reached by physicians in other parts of the Western world, including Europe, Canada, and Australia. In this commentary, a different view is presented by non-US-based physicians and representatives of general medical associations and societies for pediatrics, pediatric surgery, and pediatric urology in Northern Europe. To these authors, only 1 of the arguments put forward by the American Academy of Pediatrics has some theoretical relevance in relation to infant male circumcision; namely, the possible protection against urinary tract infections in infant boys, which can easily be treated with antibiotics without tissue loss. The other claimed health benefits, including protection against HIV/AIDS, genital herpes, genital warts, and penile cancer, are questionable, weak, and likely to have little public health relevance in a Western context, and they do not represent compelling reasons for surgery before boys are old enough to decide for themselves.
authors.affiliation: Department of Epidemiology Research, Statens Serum Institut, Copenhagen and Center for Sexology Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. mfr@ssi.dk.
authors.forename: Morten
authors.initials: M
authors.lastname: Frisch
authors.forename: Yves
authors.initials: Y
authors.lastname: Aigrain
authors.forename: Vidmantas
authors.initials: V
authors.lastname: Barauskas
authors.forename: Ragnar
authors.initials: R
authors.lastname: Bjarnason
authors.forename: Su-Anna
authors.initials: SA
authors.lastname: Boddy
authors.forename: Piotr
authors.initials: P
authors.lastname: Czauderna
authors.forename: Robert P E
authors.initials: RP
authors.lastname: de Gier
authors.forename: Tom P V M
authors.initials: TP
authors.lastname: de Jong
authors.forename: Günter
authors.initials: G
authors.lastname: Fasching
authors.forename: Willem
authors.initials: W
authors.lastname: Fetter
authors.forename: Manfred
authors.initials: M
authors.lastname: Gahr
authors.forename: Christian
authors.initials: C
authors.lastname: Graugaard
authors.forename: Gorm
authors.initials: G
authors.lastname: Greisen
authors.forename: Anna
authors.initials: A
authors.lastname: Gunnarsdottir
authors.forename: Wolfram
authors.initials: W
authors.lastname: Hartmann
authors.forename: Petr
authors.initials: P
authors.lastname: Havranek
authors.forename: Rowena
authors.initials: R
authors.lastname: Hitchcock
authors.forename: Simon
authors.initials: S
authors.lastname: Huddart
authors.forename: Staffan
authors.initials: S
authors.lastname: Janson
authors.forename: Poul
authors.initials: P
authors.lastname: Jaszczak
authors.forename: Christoph
authors.initials: C
authors.lastname: Kupferschmid
authors.forename: Tuija
authors.initials: T
authors.lastname: Lahdes-Vasama
authors.forename: Harry
authors.initials: H
authors.lastname: Lindahl
authors.forename: Noni
authors.initials: N
authors.lastname: MacDonald
authors.forename: Trond
authors.initials: T
authors.lastname: Markestad
authors.forename: Matis
authors.initials: M
authors.lastname: Märtson
authors.forename: Solveig Marianne
authors.initials: SM
authors.lastname: Nordhov
authors.forename: Heikki
authors.initials: H
authors.lastname: Pälve
authors.forename: Aigars
authors.initials: A
authors.lastname: Petersons
authors.forename: Feargal
authors.initials: F
authors.lastname: Quinn
authors.forename: Niels
authors.initials: N
authors.lastname: Qvist
authors.forename: Thrainn
authors.initials: T
authors.lastname: Rosmundsson
authors.forename: Harri
authors.initials: H
authors.lastname: Saxen
authors.forename: Olle
authors.initials: O
authors.lastname: Söder
authors.forename: Maximilian
authors.initials: M
authors.lastname: Stehr
authors.forename: Volker C H
authors.initials: VC
authors.lastname: von Loewenich
authors.forename: Johan
authors.initials: J
authors.lastname: Wallander
authors.forename: Rene
authors.initials: R
authors.lastname: Wijnen
mesh_terms: D000698:Analgesia / Q000379:methods*; D002944:Circumcision, Male; D006801:Humans; D008297:Male; D012749:Sexually Transmitted Diseases / Q000517:prevention & control*