Male circumcision is linked to a low rate of adverse events when the procedure is conducted during the infant’s first eight weeks of life.

The risk of adverse events from this procedure is 10 to 20 times higher when performed after infancy.

The guidance for male circumcision by the American Academy of Pediatrics has been updated, stating that the benefits of the procedure justify its access by parents who choose it for their sons. Because of the potential for circumcision to protect against acquisition of HIV, there has been great debate about whether or not male circumcision should be part of a public health action.

Charbel El Bcheraoui, Ph.D., of the Institute for Health Metrics and Evaluation at the University of Washington, Seattle, and colleagues chose 41 possible adverse events associated with male circumcision based on a review of literature and medical billing codes. Information and medical records stored in administrative claims of nearly 1.4 million circumcised males was closely analyzed.

The researchers found that the rate of adverse events associated with male circumcision was less than 0.5 percent. The rate of adverse events was 10 times higher in boys circumcised between the ages of one to nine years, and 20 times higher in boys circumcised after the age of 10.

“Given the current debate about whether MC should be delayed from infancy to adulthood for autonomy reasons, our results are timely and can help physicians counsel parents about circumcising their sons,” El Bcheraoui said in a statement.

The findings of the study are published in JAMA Pediatrics.