More on male circumcision...

Writing about the topic of circumcision recently netted me a somewhat surprising number of replies (though, as seems typical for this blog none appearing on the blog itself). The American Academy of Pediatrics (AAP) also released an update on the topic, probably best summarized in the following statement (although you can read the long tech report if you've got the time):

the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision.

If you look elsewhere you can find some significant evidence of flaws in the AAP report and the composition of the task force, and it's conclusions seem to be at odds with those of most other medical societies. Here, for example, is a 2009 statement from the College of Physicians and Surgeons of British Columbia:

Infant male circumcision was once considered a preventive health measure and was therefore adopted extensively in Western countries. Current understanding of the benefits, risks and potential harm of this procedure, however, no longer supports this practice for prophylactic
health benefit. Routine infant male circumcision performed on a healthy infant is now considered a non-therapeutic and medically unnecessary intervention.

Consider another article forwarded my way which claimed that "Declining rates of US infant male circumcision could add billions to health care costs". the primary impact of circumcision supposedly playing out in the realm of STDs (with other effects like uninary tract infections significantly reduced by breastfeeding and treatable by antibiotics). Note that STDs aren't something a child would have to deal, barring sexual abuse, meaning that this could be left to the individual later in life instead of in infancy. This particular article asserted that

steadily declining rates of U.S. infant male circumcision could add more than $4.4 billion in avoidable health care costs if rates over the next decade drop to levels now seen in Europe.

The most obvious idea would be to thus compare the situation of North America to Europe. How do the figures compare? As far as curable STDs are concerned, the rates of STDs in the population seem basically the same in Europe and North American (differences in the fraction of the population infected [favoring North America] and the number of new cases in the population [favoring Europe] could both be due to rounding-related issues). How about HIV? Look up the infection rate statistics, and the US had a significantly higher rate of HIV infections than each of the 5 or 6 Europe countries I looked up. Thus this study seems more reminiscent of scare tactics than anything substantive

Interestingly I also discovered that the correlation between HIV and circumcision in Africa is even worse than presented last time. Here's a statement from a 2009 US Agency for International Development report:

There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.

i.e. in a majority of countries HIV prevalence was higher amongst circumcised men. It's African data that the AAP seems fairly dependent on (despite the flaws previously noted in such studies, and with more studies also documenting such flaws).