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News release: NationalMarch 6, 2000 For more information, call: Leading experts challenge American Academy of Pediatrics' recommendation on circumcision Oakland, CA – Expressing concern about last year's statement by the American Academy on Pediatrics that does not recommend routine circumcision, pediatrician and researcher Edgar J. Schoen, MD, and coauthors Thomas E. Wiswell, MD, and Stephen Moses, MD, cite compelling reasons to support circumcision in a report published in the March issue of the journal Pediatrics. "There are clear, clinical reasons to recommend circumcision for infant boys," says lead author Dr. Schoen. "Urinary tract infections in the first year of life are far more common in uncircumcised boys than in circumcised infants, and multiple studies have shown HIV infection and penile cancer occur more often in uncircumcised men." In the article "New Policy on Circumcision--Cause for Concern," the authors cite 213 cases of penile cancer that showed risk in uncircumcised men of invasive cancer is 22 times that for circumcised men. Dr. Schoen studied 14,893 males born in 1996 and found that uncircumcised infants were 11 times more likely to develop a urinary tract infections (UTI) and 18 times more likely to be hospitalized with a UTI than infant boys who were circumcised. "Urinary tract infections in infancy can lead to hypertension and other complications such as kidney damage or chronic renal failure necessitating dialysis or kidney transplant," says coauthor Dr. Wiswell. Dr Stephen Moses, a Canadian epidemiologist, analyzed more than 30 studies showing that uncircumcised men are two to four times more likely to get HIV on sexual exposure as are circumcised men, as well as being at increased risk for acquiring other sexually transmitted diseases. Dr. Moses' conclusions have recently been confirmed by a review in the leading British journal Lancet (November 1999). Schoen et al. are responding to the AAP's policy statement* that concludes that "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision." In the same issue of Pediatrics, Dr. Schoen and Kaiser Permanente researchers Christopher J. Colby, PhD, Geoffrey Machin, MD, and Michael Oehrli, MPA, author a study of circumcision and penile cancer in elderly men. That study found that of 89 men with invasive penile cancer, 87 were uncircumcised. Dr. Wiswell is in the Departments of Pediatrics and Neonatology, at Thomas Jefferson University in Philadelphia. Dr Moses is in the Departments of Medical Microbiology, Community Health Sciences, and Medicine, at the University of Manitoba, Canada. Dr Schoen is director of Perinatal Screening for the Northern California Division of Kaiser Permanente, and is a clinical professor of pediatrics at the University of California at San Francisco. Kaiser Permanente is America's leading integrated health care organization. Founded in 1945, it is a nonprofit, group-practice prepayment program with headquarters in Oakland, California. Kaiser Permanente serves the health care needs of 8 million members in 11 states and the District of Columbia. Today, it encompasses Kaiser Foundation Health Plan, Inc., Kaiser Foundation Hospitals, and the Permanente Medical Groups, as well as an affiliation with Group Health Cooperative based in Seattle. *American Academy of Pediatrics Task Force on Circumcision. Circumcision Policy Statement. Pediatrics 1999; 103:686-93.
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