QUOTE (Turin Machine @ Mar 6 2018, 06:59 PM)
Snippet, (pun intended) from another report.
"After an extensive evaluation of the scientific evidence, the United States Centers for Disease Control and Prevention (CDC) released draft policy recommendations in December 2014 affirming male circumcision (MC) as an important public health measure."
However:
In a recently published article, Frisch and Earp6 oppose the 2014 draft MC recommendations from the U.S. Centers for Disease Control and Prevention (CDC),3 referring to what they believe are “numerous scientific and conceptual shortcomings.” Here, we quote these 7 criticisms by Frisch and Earp and provide our response to each criticism.
Failure to provide a thorough description of the normal anatomy and functions of the penile structure being removed at circumcision (i.e., the foreskin)Response: There seems to be no need for the CDC to provide a thorough description of the anatomy and functions of the foreskin.
Failure to consider the intrinsic value to some men of having an unmodified genital organResponse: While some men may believe there is “an intrinsic value to having an unmodified genital organ,” those men should be made aware of the risks posed by their foreskin.
Undue reliance on findings from sub-Saharan Africa concerning circumcision of adult males (as opposed to infants or children)Response: The evidence shows the CDC is correct in concluding that findings from sub-Saharan Africa concerning circumcision of adult males for protection against heterosexually-acquired HIV and certain other STIs also apply to men in the United States. The findings also apply to boys when they grow up. Moreover, the cumulative lifetime benefit is greatest if circumcision is performed early in infancy since early infant circumcision is simpler, more convenient, and carries lower risk than when performed later, and circumcision confers immediate protection against urinary tract infections, phimosis, balanitis, and, when older, specific STIs and genital cancers. MC also protects the female partners, as confirmed in randomized controlled trials.
Uncritical reliance on a prima facie implausible benefit-risk analysis performed by a self-described circumcision advocateResponse: The benefit-risk analysis used by the CDC is based on the best current evidence relevant to the United States, and the results are plausible.
Reliance on misreported statistics to downplay the problem of pain in the youngest of boysResponse: While procedural pain can occur during circumcision, the evidence cited by the CDC indicates that, with use of local anesthetic, pain is negligible in the first week of a boys life. Frisch and Earp misconstrue pain statistics to overplay the issue of pain.
Reliance on incomplete register data to assess the frequency of short-term post-operative complications associated with circumcision, leading to a likely underestimation of their true frequencyResponse: By selective citation and misrepresentation of findings, Frisch and Earp overstate the frequency of short-term postoperative complications associated with MC while ignoring data from large high-quality studies such as those published recently by CDC researchers.
Serious underestimation of the late-occurring harms of circumcision presenting months to years after the operation (most notably meatal stenosis).Response: Frisch and Earp selectively cite small, outdated, weak studies, often involving traditional circumcisers, and misrepresent data while ignoring large, high-quality studies. As a result, they overestimate the frequency of meatal stenosis occurring years after the MC procedure.