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Factors affecting the practice of circumcision

D A Patel, E G Flaherty, J Dunn

    American Journal of Diseases of Children (1960)
    |July 1, 1982
    PubMed
    Summary

    Despite the American Academy of Pediatrics' 1975 statement against routine newborn circumcision, many physicians remained unaware and continued recommending the procedure, with hospital rates unchanged.

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    Area of Science:

    • Pediatric Medicine
    • Public Health Policy

    Background:

    • In 1975, the American Academy of Pediatrics (AAP) issued a policy statement indicating no medical necessity for routine newborn circumcision.
    • This statement aimed to influence clinical practice and parental decision-making regarding infant circumcision.

    Purpose of the Study:

    • To assess the awareness of the AAP's 1975 policy among Chicago-area physicians (pediatricians, obstetricians, family practitioners).
    • To determine the impact of the AAP's statement on physicians' recommendations and hospital circumcision rates.

    Main Methods:

    • Surveys were administered to physicians and hospitals in the Chicago metropolitan area.
    • Data collected included physician awareness of the AAP policy, their recommendations on circumcision, and hospital circumcision frequencies before and after 1975.

    Main Results:

    • Only 49% of surveyed physicians were aware of the AAP's 1975 position on newborn circumcision.
    • Physician recommendations varied: 41% recommended routine circumcision, while 15% advised against it.
    • Factors influencing physician recommendations included age, medical specialty, religious customs, and concerns about hygiene and cancer.
    • Hospital circumcision rates remained high (70%-90%) and showed no significant change in the three years following the AAP's statement.

    Conclusions:

    • The AAP's 1975 policy statement had minimal impact on physician awareness and clinical practice regarding newborn circumcision in the surveyed Chicago-area population.
    • Physician attitudes towards circumcision were influenced by a complex interplay of professional, cultural, and personal factors.
    • Further interventions may be needed to effectively disseminate and implement evidence-based guidelines in clinical practice.

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