July 16, 1997

Advantages and Disadvantages of Neonatal Circumcision

Author Affiliations

Southeast Georgia Regional Medical Center Brunswick

JAMA. 1997;278(3):201. doi:10.1001/jama.1997.03550030041021

To the Editor.  —Dr Laumann and colleagues1 conclude that circumcision provides no preventive medical benefit, thus reviving an ongoing controversy. While issues related to the risk of childhood urinary tract infection with and without circumcision may be debatable, the authors have been blinded to the medical benefits of circumcision for adults. Indeed, only 1 week following the report by Laumann et al, Royce et al2 reported that "male circumcision consistently shows a protective effect against HIV infection," with an 8-fold increased rate of HIV disease among uncircumcised men.2 Royce et al further report a greater incidence of HIV in sexual partners of uncircumcised men and speculate that the abundance of Langerhans cells in the foreskin may be a contributing factor and that the presence of a foreskin actually may increase infectiousness.Periodic arguments against circumcision have been supported by a variety of evidence, much of which has been directed toward