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| Circumcision policy under fire |
22-Feb-2006 |
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By Rebecca Jenkins
AN Australian medical college has been accused of inaccuracies and “thinly veiled propaganda” in its circumcision policy.
Circumcision advocate Professor Brian Morris, of the University of Sydney’s school of medical sciences, said the Royal Australian College of Physicians’ policy was not evidence based and should be retracted.
The 2004 RACP statement concluded that, after a literature review, “there is no evidence of benefit outweighing harm for circumcision as a routine procedure in neonates”.
Writing in the Australian and New Zealand Journal of Public Health, Professor Morris and others claimed the statement downplayed the benefits of circumcision for the prevention of UTIs, penile and cervical cancer, genital herpes and chlamydia in women, and HIV infection. He also said the statement overstated the complication rates of the procedure.
“There are so many benefits of circumcision that the RACP should be taking a leadership role in promoting awareness of these,” they wrote.
The authors also argued the college made circumcision appear uncommon, stating that10-20% of Australian male infants are routinely circumcised.
Although Medicare statistics show a rate of 17%, the authors argue that this is an underestimate of the true rate because this fails to include procedures performed in public hospitals or through private consultations.
In a critical commentary in the journal, epidemiologist Dr Juliet Richters, of the National Centre for HIV Research at the University of NSW, said the RACP working party was to be commended for its “even-handed treatment” of the issue.
Dr Richters accepted that the college’s statement omitted some relevant evidence, but said “in a situation of genuine scientific controversy, it is responsible to take the conservative position”.
A spokeswoman for the RACP declined to comment, but said policies were reviewed biennially and the circumcision statement would be reassessed this year.
Australian and New Zealand Journal of Public Health 2006; 30:16-21, 22-24, 25.
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