REUTERS, Friday, September 29, 2000.

Misdiagnosis May Lead to Needless Circumcisions in UK

NEW YORK (Reuters Health) - Too many unnecessary circumcisions are being performed in the UK, British researchers report. Currently, about 3.8% of boys in England are circumcised. However, only about 0.6% of boys actually require the procedure due to medical necessity, a report suggests.

The main cause of unnecessary circumcisions is misdiagnosis of phimosis--a condition in which the foreskin cannot be pulled back over the head of the penis, according to the report published in the September 30th issue of the British Medical Journal.

``Too many English boys, especially those under 5 years of age, are still being circumcised because of misdiagnosis of phimosis,'' write Anthony. M. K. Rickwood, of the department of urology at Alder Hey Children's Hospital in Liverpool, and colleagues.

``At birth, the foreskin is almost invariably non-retractable, but this is transient and resolves in nearly all boys as they mature,'' the authors note.

What's more, ``a reduction in the proportion of English boys circumcised to an attainable target of 2% would make for about 6,000 fewer circumcisions each year, with a corresponding saving of 3 million pounds.''

Although the exact frequency is unknown, it is estimated that 1.2 million newborn males are circumcised in the United States annually at a cost of between $150 million and $270 million. This practice has been advocated for reasons that vary from symbolic ritual to preventive health measures. Until the last half century, there has been limited scientific evidence to support or repudiate the routine practice of male circumcision, according to the American Academy of Pediatrics.

``Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child,'' the AAP writes in a policy statement.

SOURCE: British Medical Journal 2000;321:792-793.

[CIRP Note: CIRP estimates that if the U.S. non-therapeutic neonatal circumcision rate was to be reduced from about 60 percent to 2 percent, there would be about 1,044,000 fewer circumcisions performed annually, at an annual cost savings of at least $208,800,000.00 in surgeon's fees alone without regard for hospital charges.]

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(File created 29 September 2000)

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