Male circumcision worthwhile: expert

Nov 3, 2003

Australia needed to rethink its opposition to male circumcision amid growing evidence the practice offered significant health benefits for both men and women, a medical conference was told.

Recent studies showed circumcision protected men against HIV and lowered the risk of cervical cancer in their female partners, Roger Short of Melbourne University told the Fertility Society of Australia's Annual Scientific Meeting in Perth.

Australia had an "unduly negative" attitude towards male circumcision and needed to do a major rethink, Prof Short told AAP.

"Evidence shows male circumcision reduces by two- to eight-fold a man's risk of becoming HIV positive," he said.

"So on a global scale we've really got to start taking male circumcision seriously as an option."

Prof Short said a number of studies demonstrating this had been published in the last three years.

The most recent research, based on a study of Indian men beginning in 1993, showed an eightfold reduction of HIV in those who had been circumcised, Prof Short said.

Another study by the London School of Hygiene and Tropical Medicine, which analysed existing literature, found a man's risk of being HIV positive was halved if he was circumcised.

The reason for these findings was simple, Prof Short said.

"The main site by which HIV enters the penis is through the inner aspect of the foreskin, where there's no keratin covering which normally keeps the virus out and there's a very high concentration of cells with receptors for the virus that internalise it," he said.

"If you take the foreskin away you remove most of the receptor sites for HIV so you drastically reduce risk."

Prof Short said other studies had shown that circumcised men were also less likely to be infected with the Human Papilloma Virus (HPV), which is responsible for 99 per cent of cervical cancer when passed on to women.

Prof Short said more studies were needed "before we say the world should be circumcised".

However, he said, circumcision could be considered as a cheap and effective protective measure in places like Africa where HIV is out of control and where there is a lack of access to medicines.

"I certainly wouldn't say every newborn baby boy ought to be circumcised," he said.

"But now with this data showing there is a major effect on female repro health even in developed countries irrespective of the HIV scene I really think we've got to do a big rethink."

The Royal Australasian College of Physicians (RACP) advises there is no medical reason for the routine circumcision of boys.

"Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure," it says in a position statement.

Circumcision rates in Australia have fallen recently with only 10 per cent of male infants currently believed to be having it done.

©AAP 2003