The following circumcision "researcher" flubs were highlighted on Circumstitions News.
Circumcision "Researchers" in Africa: "Oops"
First on the bill are the three big African "circumcision trials." Apparently, the fact that two of them were registered late went unnoticed. That is, until recently.
According to trial registration documents, the South African trial was registered a year and a half after recruitment ended and seven days before the results were published! The Ugandan one a month after recruitment ended, and a month before publication.
It looks like PLOS One and The Lancet wanted to publish impressive high impact trials, but found they weren’t registered. To get around this, it looks like they got the authors to do it retrospectively, and hoped no one would notice!
Discrepancies and/or absurd correspondences between the plans and the outcomes as a result of the late registration can be observed, for example, that the South African trial got EXACTLY as many subjects (3274) as planned.
"Gold standard" indeed!
(For more details, read the article and Hugh Young's commentary here.)
US Circumcision Death Rate May Be 156 Annually: Thx Prof. Morris!
Next up, a Brazilian study, which evaluates circumcisions performed at Brazilian hospitals within a 27 year period, has been reportedly circulated by Australian circumcision enthusiast Bryan Morris, presumably because he likes the "very low mortality rate" associated with the procedure.
For the study, researchers used figures from the Unified Health System database from 1984 to 2010. A total of 668,818 men were admitted to public hospitals for circumcisions to treat diagnoses of phimosis.
The researchers found that there were 63 deaths associated with circumcision within a 12 year period (1992 to 2010) for a mortality rate of 0.013%.
Brian Morris must have been jumping for joy to see this figure. Except, that percentage hides a rate of 1 in 7692 circumcisions (63 out of 484,596 circumcisions in a 12 year period). An estimated 1.2 million newborn boys are circumcised in the United States yearly, where this rate would mean 156 circumcision deaths per year.
Forget the fact that phimosis is often misdiagnosed, putting into question the necessity of a percentage of the circumcisions examined; this number far exceeds Bollinger's estimation of 117 circumcision deaths per year.
It is difficult to come up with an accurate estimate as to the deaths caused by circumcision, because hospitals aren't expected to report this data, and/or because doctors often deliberately misattribute them to other causes to avoid a lawsuit.
But thanks to Professor Brian Morris, we may now have a better idea.
(For more details, read the article and Hugh Young's commentary here.)
In my opinion, Hugh Young of New Zealand is about as smart as any other intactivist in the world.
ReplyDeleteI agree that the recently reported Brazilian rate is shockingly high.
I agree that there is no truthful data on how many North American babies die after being circumcised. A conservative estimate, in my opinion, would be 15-50 a decade, a lot than less than Bollinger's estimate or Brazilian data. But that many deaths is good reason, IMHO, to stop the practice.
As much as I would like to accept the Brazillian data as being applicable to newborn circ...it isn't. Circumcision in adult males supposedly is riskier than in newborns. I don't know if that is really true or not--I don't think anyone really does since the sacred cow of routine infant circ is not honestly studied in America. But until we know for certain...comparing adult circ to infant circ is comparing Red Delicious to Granny Smith apples--they are similar, yet very different.
ReplyDelete"As much as I would like to accept the Brazillian data as being applicable to newborn circ...it isn't."
DeleteWell, Brian Morris certainly doesn't seem to think so... ;-)
"Circumcision in adult males supposedly is riskier than in newborns. I don't know if that is really true or not--I don't think anyone really does since the sacred cow of routine infant circ is not honestly studied in America."
Don't make statements you're not sure about.
Why in the world would cutting up a bigger penis be riskier than cutting up a tiny penis, where partial or full ablation accidents have been known in babies, but are rare or unheard of in adults?
It's also easier for a baby to hemorrhage to death, since it only takes a very small amount of blood loss for this to happen.
But you're right; according to the AAP, these risks are unknown, and, it looks like American physicians aren't very interested in knowing.
"But until we know for certain...comparing adult circ to infant circ is comparing Red Delicious to Granny Smith apples--they are similar, yet very different."
Now if only Brian Morris and everyone who thinks trials on adult men in high-risk areas in Africa apply to infants in 1st world countries could understand this, it would be great.