Win32 Virus Removal

Every parent of a newborn boy is asked the same question: to circumcise or not?

Circumcision, the removal of the foreskin on the penis, has been debated over the years among the medical community and parents.

Scientific evidence has been mixed on whether one way is better than the other for preventing health problems such as urinary tract infections, cancer and sexually transmitted diseases.

But fewer parents may be choosing to have their boys circumcised, according to the U.S. Centers for Disease Control and Prevention.

Preliminary data that the CDC presented at an international HIV/AIDS conference show that the number of newborn boys circumcised in the United States dropped from 56 percent in 2006 to 33 percent in 2009.

While Middle Tennessee doctors say anecdotally that they have not seen a decline in parents deciding to circumcise, they feel it is a decision parents should make based on the supposed benefits and risks. No state agency or hospital formally tracks circumcisions.

"It's an interesting debate that has been going on for a long time," said Dr. Lawrence Klinsky, a pediatrician with Heritage Medical Associates. "There is no clear-cut answer. There are some minor medical benefits."

About 80 percent of men in the United States are circumcised, but that has been trending downward, CDC data show.

Some believe benefits of the procedure, which is typically done in the first few days of the newborn's life, are lower risk of urinary tract infections, penile cancer and sexually transmitted diseases, including HIV/AIDS, according to the National Institutes of Health.

The risks, the federal health agency points out, include pain and a low risk of bleeding or infection, though these risks are higher for older babies, boys and men. Also, there is belief that circumcision may decrease sexual sensitivity for men, though studies are inconclusive.

"If parents are considering the procedure, it is better to do it in the hospital," said Klinsky, who also serves as physician clinical leader in Baptist Hospital's childbirth center.

SDI Health, a company that analyzes health industry data and trends, compiled the figures that the CDC presented showing a decline in circumcision. A CDC spokeswoman said the outside data would need to be confirmed with follow-up surveys.

A spokesman for SDI said the company could not release information about how it collected the data because the project is still in progress.

Last decline was in '05

The last decline for circumcision that the CDC documented was when the numbers of newborn circumcisions dropped from 60 percent in 1998 to 55 percent in 2005. In 1980, newborns were circumcised about 65 percent of the time.

The CDC plans to release new guidelines, probably in 2011, about circumcision and whether it helps to prevent transmission of HIV, the virus that causes AIDS. The agency has not said which way it might lean.

Dr. Mary Keown, chairwoman of pediatrics at Centennial Medical Center, said a lot of parents decide based on whether the father was circumcised, or go with what their religion dictates.

"It usually comes down to the dads who want (their boys) to look like them and like every other guy in the locker room," she said.

The procedure can take up to 20 minutes and usually involves a local anesthetic to numb the site where the foreskin will be cut. There is about a two-week healing period.

The American Academy of Pediatrics does not take a position on circumcision and says that in cases where the procedure is not a medical necessity, parents should make their own informed decision.

Keown has seen older boys who have had to have a circumcision anyway because they get a chronic infection. At an older age, the procedure can be more painful and riskier.