During my meetings with parents-to-be, by far, the most common question I am asked involves vaccines. But for those who are about to have a son, I am also commonly asked for my perspective regarding neonatal circumcision. And my response to this point has been pretty standard: if religious/cultural obligations do not exist, I share with parents the American Academy of Pediatrics (AAP) - Circumcision Policy Statement (now about 10 years old but reaffirmed just 4 years ago) which basically states there is not enough scientific evidence to support routine neonatal circumcision. I do believe the basic premise of "like father, like son" and will often turn to the father-to-be and make sure he understands some questions may arise later in life when his son discovers he is different from his father. And I may also reference a research article (usually performed in Africa) which demonstrates some reduced risk of acquiring sexually transmitted infections (STIs), but beyond that, I've avoided pointing parents in one direction or another.
But I'm wondering if this is about to change as it appears those interesting research articles (again, usually performed in Africa) are growing in number. Just recently, a report published in the International AIDS Society journal found that circumcising 500,000 males in Botswana by 2012 may prevent up to 70,000 new HIV infections by 2025 as previous studies found uncircumcised men were 2-3 times more likely to acquire HIV when compared to circumcised men. Furthermore, because the rates of penile cancer vary throughout the world, it does prompt one to consider what risk factors may be in place to explain these differences. And while I admit the research studies examining the role of circumcision on penile cancer are not the greatest, there is enough theoretical evidence to support that appropriate care of an uncircumcised male (ensuring the foreskin is fully retractable by the time the child is 5 or 6 years of age and cleansed routinely) is important in preventing transmission of certain STIs, particularly ones linked to penile cancer in males and cervical cancer in females (please see my next immunization discussion regarding human papillomavirus (HPV) for further details).
So while I cannot speak upon behalf of the AAP regarding any official policy change, I certainly believe it is essential that parents of males have all the information and at this point, if a circumcision is not to be done, appropriate hygiene and care must be undertaken beginning at a young age.