WebMD Medical News
Laura J. Martin, MD
Sept. 1, 2011 -- Circumcision rates in the U.S. are on the decline, according to a CDC study.
The CDC used three different measurements to estimate the number of newborn male circumcisions. Researchers found that the procedure is somewhat less common today than it was 10 years ago.
The report was written in the wake of increasing evidence that circumcision greatly reduces the risk of contracting HIV during penile-vaginal sex.
"The publication of three recent studies showing that circumcision of adult, African, heterosexual men reduces their risk for acquiring human immunodeficiency virus infection and other sexually transmitted infections has stimulated interest in the practice of routine newborn male circumcision," the researchers write.
Several other sexually transmitted diseases (STDs) have been associated with a lack of circumcision. These include genital ulcer disease and chlamydia. Infant urinary tract infections and penile cancer have also been linked with STDs.
Women who have sex with uncircumcised men appear to be at higher risk of cervical cancer. And a lack of circumcision has been linked to the spread of human papillomavirus (HPV) infection. HPV can cause cervical cancer.
Complications from circumcision are rare, according to the CDC. The most common are minor bleeding and local infection.
According to the CDC, circumcision rates increased from 48.3% to 61.1% between 1988 and 2000.
In 1999, the American Academy of Pediatrics declared that there was not enough data to recommend the routine circumcision of baby boys. They reaffirmed their position in 2005.
That position, according to the CDC, may have contributed to the current drop in circumcision rates. For example, the position may have had an influence on whether insurance companies reimburse for the procedure. It also may have altered decision-making by parents on circumcising their sons.
The new report reveals that in all three measurements used by the CDC, the number of circumcisions performed dropped over the last decade. For example, the National Hospital Discharge Survey, conducted by the National Center for Health Statistics, showed that of the nearly 20 million babies surveyed, fewer than 12 million were circumcised between 1999 and 2008. That's a decrease from 62.5% to 56.9% over that decade. The other two measurements showed similar decreases.
The researchers point out that health coverage likely plays a significant role in circumcision rates. Hospitals in the 33 states where routine circumcision is covered by Medicaid had rates that were 24% higher than in hospitals that lacked such coverage.
The CDC says on its web site that it is still developing its own recommendations concerning circumcision. In the meantime, "individual men may wish to consider circumcision as an additional HIV prevention measure ... in conjunction with other proven prevention measures (abstinence, mutual monogamy, reduced number of sex partners, and correct and consistent condom use)."
SOURCES:Morbidity and Mortality Weekly Report, Sept. 2, 2011; vol 60: pp 1167-1168.CDC web site: "Male Circumcision and Risk for HIV Transmission and Other Health Conditions: Implications for the United States."American Academy of Pediatrics web site: "Circumcision."
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