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U.S. Circumcision Rate Drops Over Last 3 Decades, Report Says

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BABY BOY WRAPPED IN BLANKET
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By: By Rachael Rettner, Senior Writer
Published: 08/22/2013 06:54 AM EDT on LiveScience

The percentage of newborns who are circumcised in the United States has been on the decline in recent decades, according to a new report from the Centers for Disease Control and Prevention (CDC).

Between 1979 and 2010, the rate of newborn circumcision among males declined from 64.5 percent to 58.3 percent, the report found.

The rate was highest in 1981, at 64.9 percent, then declined during the 1980s, rose again in the 90s, and fell again in the 2000s, reaching a low of 55.4 percent in 2007, the report said.

The biggest overall decline was seen in the West, where the rate dropped from 63.9 percent in 1979 to 40.2 percent in 2010. At its lowest point in 2003, the circumcision rate of male newborns in the West was just 31.4 percent. [5 Things You Didn't Know About Circumcision]

The fluctuations in rates occurred during the same time period as changing recommendations regarding circumcision, said study researcher Maria Owings, a health statistician at the CDC's National Center for Health Statistics.

In 1989, the American Academy of Pediatrics said that there were potential benefits to circumcision, but in 1999, the organization said there was insufficient evidence to recommend the procedure.

Another factor that may influence circumcision rates is reimbursement by insurance. According to a 2012 study, Medicaid policies in 18 states have stopped covering routine infant circumcision in recent years. Another study found that hospitals in states where Medicaid covers circumcision had rates that were 24 percent higher than those in states that did not cover the procedure.

Changes in ethnic make-up of the country may also affect circumcision rates, said Dr. Michael Brady, a pediatrics expert and Physician-in-Chief at Nationwide Children's Hospital in Columbus, Ohio. Brady noted that most regions of the United States have had fairly stable circumcision rates, in contrast to the declining rates in the West.

Over the last 30 years, the United States has also had an increase in the number of people of who identify as Hispanic, particularly in the West. And Hispanic people typically have lower rates of circumcision, around 40 percent, Brady said.

"Some of the decline may be related to the fact that our demographics have changed," Brady said.

Last year, the AAP said the health benefits of circumcision outweighed the procedure's risks, but the organization still did not recommend the procedure, saying that the decision to circumcise should be left up to the parents.

Studies from Africa showed that circumcision reduces the risk of acquiring HIV by 40 to 60 percent in men, the AAP says. There is also good evidence to suggest circumcision lowers the risk of human papillomavirus (HPV) infection, and infection with some strains of genital herpes, according to the AAP.

Circumcision has also been linked with a threefold to 10-fold reduction in the risk of urinary tract infection in boys ages 2 or younger, although the rate of urinary tract infection in young boys is very low.

Acute complications of circumcision, including infection and bleeding, are rare, and occur in about 1 in every 500 circumcisions, the AAP says. Circumcision does not appear to affect male sexual function or sensitivity, the AAP says.

It's too early to say whether the 2012 AAP statement will lead to a boost in circumcision rates, Brady said. But it should lead to more parents being adequately informed about the risks and benefits of the procedure, he said.

Follow Rachael Rettner @RachaelRettner. Follow LiveScience @livescience, Facebook & Google+. Original article on LiveScience.

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