THURSDAY, Aug. 22 (HealthDay News) -- Male circumcision rates in
the United States declined 10 percent between 1979 and 2010,
federal health officials reported Thursday.
Over 32 years, the rate of newborn circumcision -- the surgical
removal of foreskin from a penis -- performed in hospitals dropped
from 64.5 percent to slightly more than 58 percent, according to
the U.S. Centers for Disease Control and Prevention.
"It hasn't been a stable decline," said report co-author Maria Owings, a health statistician at CDC's National Center for Health Statistics.
Over the decades the rate of circumcision in hospitals varied
from a high of nearly 65 percent in 1981 to a low of slightly more
than 55 percent in 2007, Owings said.
The rates also fluctuated over time, generally dropping during
the 1980s, going up in the 1990s and dropping again in the early
years of the 21st century, she said.
Part of the variation in rates reflects changes in guidance from
medical groups, such as the American Academy of Pediatrics (AAP),
according to the report.
In the 1970s the AAP said routine circumcision had no medical
benefit. However, in 1989 the academy revised its position and said
there were potential benefits to the procedure after all. But in
1999 the academy said that despite these benefits there was not
enough evidence to recommend routine circumcision.
Current AAP guidelines offer evidence of the benefits of
circumcision, especially in terms of preventing the transmission of
HIV, the virus that causes AIDS.
The guidelines also say that circumcision lowers the risk of
urinary tract infections in infants, genital herpes, human
papillomavirus, cervical cancer in women and penile cancer.
Even so, the AAP still stops short of recommending circumcision
for all baby boys.
AAP President Dr. Thomas McInerny said he thinks the change in
circumcision rates is due to changes in the way doctors and
families interact when deciding on the procedure.
"Parents are making shared, or what we call informed, decisions now," he said. "In years gone by, when you told patients they should do this or that, most of the time they said 'yes doctor' and they didn't ask any questions."
These days, doctors are giving more "family-centered" care and
shared decision making, he said. "I think that's a healthy way of
practicing medicine," McInerny said.
"In addition, there are a significant number of people who feel circumcision is unnatural," he said.
McInerny noted that the procedure does have a slight risk of
excessive bleeding and infection. During the procedure infants can
feel some pain, but doctors use Novocaine to reduce the pain, he
"The benefit of circumcision outweighs the very small risk, and therefore it is recommended, but it is not strongly recommended," McInerny explained.
McInerny said circumcision is more common in the United States
than it is in Europe. "I am not sure why that is," he added. The
reasons may be religious and cultural, he suggested.
Dr. Kenneth Bromberg, chairman of pediatrics at the Brooklyn
Hospital Center in New York City, said that whether to circumcise
an infant is really not a medical decision.
"It may well be there is an increase in the number of religious groups that believe in circumcision and when done in a religious fashion it is not necessarily done in the hospital," he said. "So there might not be the decrease the researchers suggest."
For Jews and Muslims it's a religious decision, not a medical
one. "It's a personal decision and has moved outside the medical
world," Bromberg said.
In addition to the national trend, changes in the circumcision
rate reflect regional differences across the nation.
In the Northeast, the trend remained flat over the 32 years,
with no evident pattern, the investigators found. Annual
circumcision rates, however, did vary from nearly 70 percent in
1994 to about 61 percent in 2007.
In the Midwest, changes in rates mirrored the national trend.
Circumcisions declined until the mid-1980s, increased until 1998,
and then declined through 2010. Rates ranged from about 83 percent
in 1998 to roughly 69 percent in 2009, the researchers found.
In the South, rates increased from 1979 until 1998, then
declined, ranging between about 54 percent in 1988 to 66 percent in
In the West, changes were magnified. There, rates decreased 37
percent overall, from about nearly 64 percent in 1979 to just above
40 percent in 2010. The biggest decrease occurred in the 1980s,
when the rate dropped to 41 percent in 1989, continued to decrease
through 2010 and reached a low of about 31 percent in 2003,
according to the report.
CDC researchers used data from the National Hospital Discharge
Survey for their report.
To learn more about circumcision, visit the
U.S. National Library of Medicine.
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