NEONATAL CIRCUMCISION REVISITED

Objective: To assist physicians in providing guidance to parents regar ding neonatal circumcision. Options: Whether to recommend the routine circumcision of newborn male infants. Outcomes: Costs and complication s of neonatal circumcision, the incidence of urinary tract infections, sexually transmitted diseases and cancer of the penis in circumcised and uncircumcised males, and of. cervical cancer in their partners, an d the costs of treating these diseases. Evidence: The literature on ci rcumcision was reviewed by the Fetus and Newborn Committee of the Cana dian Paediatric Society. During extensive discussion at meetings of th e committee over a 24-month period, the strength of the evidence was c arefully weighed and the perspective of: the committee developed. Valu es: The literature was assessed to determine whether neonatal circumci sion improves the health of boys and men and-is a cost-effective appro ach to preventing penile problems and associated urinary tract conditi ons. Religious and personal values were not included in the assessment . Benefits, harms and costs: The effect of neonatal circumcision on th e incidence of urinary tract infection, sexually transmitted diseases, cancer of the penis, cervical cancer and penile problems; the complic ations of circumcision; and estimates of the costs of neonatal circumc ision and of the treatment of later penile conditions, urinary tract i nfections and complications of circumcision. Recommendation: Circumcis ion of newborns should not be routinely performed. Validation: This re commendation is in keeping with previous statements on neonatal circum cision by the Canadian Paediatric Society and the American Academy of Pediatrics. The statement was reviewed by the infectious Disease Commi ttee of the Canadian Paediatric Society. The Board of Directors of the Canadian Paediatric Society has reviewed its content and approved it for publication. Sponsor: This is an official statement of the Canadia n Paediatric Society. No external financial support has been received by the Canadian Paediatric Society, or its members, for any portion of the statement's preparation.