Following the new affirmative policy statement revealed by the American Academy of Paediatrics (AAP) in 2012, a group of researchers led by Dr Brian Morris, a professor emeritus at the University of Sydney has recently claimed that circumcision should be a desirable public health intervention.

According to Morris, more than one in two uncircumcised males will suffer from an adverse medical condition caused by their foreskin throughout their lifetime. He said permitting male circumcision only for medical reasons was "penny wise, pound foolish".

Benefits of circumcision found to exceed risk 200:1

In their systematic review on male infant circumcision, Dr Morris and his fellow researchers from University of New South Wales and several teaching hospitals found that the benefits of the procedure exceed the associated risk by 200 to one.

The study also reports that uncircumcised males face an 80% risk of developing a foreskin-related condition, which requires medical attention. On the other hand, the risk of an ”associated adverse event” from the circumcision procedure, the surgical removal of the foreskin of the penis, is about one in 250; In other words, less than 1%.

The studies had determined that male circumcision, to some extent, helps to protect males from urinary infections, inflammatory conditions, sexually transmitted infections and genital cancers as well as the level of risk posed by the circumcision procedure in infancy.

"The enormous benefit but low risk makes early infant circumcision similar to childhood vaccination," said Dr Morris.

Meanwhile, a new analysis led by researchers at Fred Hutchinson Cancer Research Centre in the United States found that circumcision before a male's first sexual intercourse may help protect against prostate cancer. The study also suggests that circumcision can hinder infection and inflammation that may lead to this malignancy.

Another study carried out in Johns Hopkins University Bloomberg School of Public Health also showed that circumcision is associated with a significant decline in the number of new male HIV infections in rural Ugandan communities.

However, there has been debate regarding both the potential health benefits and the ethical as well as human rights issues relating to infant male circumcision.

But the Royal Australasian College of Physicians disagrees

In Australia, even though cosmetic circumcision is banned at the public hospitals, the surgery can be carried out privately.

The Royal Australasian College of Physicians (RACP) holds a differing view with the claim but accepts that there are contradictory medical and non-medical opinions on the often highly emotive and cultural issue of infant male circumcision.

The college's position statement on the highly emotive issue also lists "cancer of the penis in men with a history of phimosis" and "cancer of the cervix" in some women as conditions that may benefit from circumcision. Still, the current position of Australian physicians on male infant circumcision is that the procedure is "generally safe" but there are risks of minor complications and some "rare but serious" complications.

"The RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision for healthy male infants in Australia and New Zealand," a RACP spokesperson said.

Dr Tony Bartone, vice president of the Australian Medical Association, says the study needs to be further evaluated by the wider medical community.

"Yes, the risk-benefit they talk about is obviously in favour with proceeding with circumcision but a number of the risks are still so low incidence you need to keep that in mind," said Bartone.

"Every case needs to be dealt with on a one-to-one basis with the appropriate information and education," he added. MIMS

Read more:
Gaps in medical knowledge: Do doctors really know best?
MOH Malaysia: Doctors need to be trained before performing circumcisions
Female circumcision: A common practice in Malaysia and Singapore

Morris, Brian J., et al. “Early Infant Male Circumcision: Systematic Review, Risk-Benefit Analysis, and Progress in Policy.”
World Journal of Clinical Paediatrics, vol. 6, no. 1, 2017, pp. 89-102. doi: 10.5409/wjcp.v6.i1.89.