Male Infant Circumcision
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Headline

Between 2001 and 2003, the percentage of male infants who were circumcised in the hospital decreased from 63 percent to 56 percent, the lowest percentage recorded since 1979. (See Figure 2)

Importance

Parents often choose to circumcise their infant sons because of religious, cultural, or health reasons. Some research shows that circumcision reduces the risks of various diseases. Boys who remain uncircumcised are at a greater risk for Urinary Tract Infection,¹ the human papilloma virus,² and penile cancer, although the risk of contracting penile cancer among both circumcised and uncircumcised men is small.³ Circumcision may also reduce the risk of contracting HIV, although findings to date are insufficiently strong to be definitive.^4,5 However, occasionally, complications such as bleeding or infection may occur with circumcision.⁶ Additionally, some research shows that infants feel pain when experiencing circumcision that may continue after the circumcision is complete.⁷

In its most recent policy statement, the American Academy of Pediatrics recommends that parents be well-informed about the benefits and risks of circumcision before deciding what is best for their own sons. If parents choose to circumcise their infant sons, the AAP recommends that procedural analgesia be provided.⁹ More information is available for parents at:
http://www.medem.com/search/article_display.cfm?path=\\TANQUERAY\M_ContentItem&mstr=/M_ContentItem/ZZZJZMEMH4C.html&soc=AAP&srch_typ=NAV_SERCH.

Trends

Between 1979 and 2001, the percentage of male infants who were circumcised in the hospital remained relatively constant, ranging between 59 percent and 65 percent. However, between 2001 and 2003, the percentage of male infants circumcised decreased from 63 percent to 56 percent. (See Figure 2)

The percentage of male newborns in the western region of the United States receiving circumcisions has significantly decreased, from 64 percent in 1979 to 31 percent in 2003. (See Figure 1) This decrease may be reflective of an increase in the proportion of births to Hispanics, who have been found to be less likely to receive circumcisions than are white and black male infants.¹⁰

Differences by Region

Male infants born in the Midwest were about two and a half times as likely as male infants born in the West to have been circumcised in 2003 (78 percent versus 31 percent, respectively). The same year, 65 percent of male infants born in the Northeast and 58 percent of male infants born in the South were circumcised. (See Figure 1)

Differences by Race

In 2003, black male infants were more likely than white male infants to have been circumcised (63 percent versus 58 percent, respectively). However, until the early 1990s, white male infants were about 8-percentage points more likely than black male infants to have been circumcised. (See Figure 2) IIt is important to note that these estimates include data for Hispanic infants. Other studies show that non-Hispanic white infants are significantly more likely than black or Hispanic infants to be circumcised.¹¹

Related Indicators

None available at this time

State and Local Estimates

None available

International Estimates

Estimates for the United Kingdom, Australia, Canada, and New Zealand are available at http://www.cirp.org/library/statistics/

National Goals

None available

What Works: Programs and Interventions that May Influence this Indicator

None available at this time

Research References

¹Schoen, Edgar J., Colby, Christopher J., and Ray, Thomas. (April 2000). "Newborn circumcision decreases incidence and costs of Urinary Tract Infections During the First Year of Life," Pediatrics 105(4): 789-793.

²"Male Circumcision Reduces Risk of Both Acquiring And Transmitting Human Papillomavirus Infection," International Family Planning Perspectives, 28(3): 179-180.

³American Academy of Pediatrics. (1999). "Circumcision Policy Statement," Pediatrics 103(3): 686-693. Available at:
http://aappolicy.aappublications.org/cgi/reprint/pediatrics;103/3/686.pdf

⁴Bailey, Robert C., Plummer, Francis A., and Stephen Moses. "Male circumcision and HIV prevention: current knowledge and future research directions," THE LANCET Infectious Diseases 1 (November 2001): 223-231.

⁵U.S. Aid. Male Circumcision: Current Epidemiological and Field Evidence-Program and Policy Implications for HIV Prevention and Reproductive Health. September 18, 2002. Available at:
http://www.rho.org/html/menrh_mtg_mc_09_02.html

⁶American Academy of Pediatrics. (1999). "Circumcision Policy Statement."

⁷Warnock, Fay and Dilma Sandrin. "Comprehensive description of newborn distress behavior in response to acute pain (newborn male circumcision)," Pain 107(2004): 242-255.

⁸American Academy of Pediatrics. (1999). "Circumcision Policy Statement."

⁹ Ibid.

¹⁰National Center for Health Statistics. Trends in Circumcision Among Newborns. May 25, 2004. Available at:
http://www.cdc.gov/nchs/products/pubs/pubd/hestats/circumcisions/circumcisions.htm

¹¹American Academy of Pediatrics. (1999). "Circumcision Policy Statement."

¹²American Academy of Pediatrics, Circumcision Information for Parents. Available online at:
http://www.medem.com/search/article_display.cfm?path=\\TANQUERAY\M_ContentItem&mstr=/M_ContentItem/ZZZJZMEMH4C.html&soc=AAP&srch_typ=NAV_SERCH

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Definition

Newborn males with circumcisions performed during short-stay hospital visits. This does not include newborn males who were circumcised elsewhere. Circumcision is a surgical procedure in which the skin covering the end of the penis (foreskin) is removed.¹²

Data Source

Total estimates and data for 2000-2003 are from:
Child Trends' original analysis of National Hospital Discharge Survey data.

All other estimates are from:
National Center for Health Statistics. Trends in Circumcision Among Newborns. May 25, 2004: Tables 1 and 2. Available at: http://www.cdc.gov/nchs/products/pubs/pubd/hestats/circumcisions/circumcisions.htm

Raw Data Source

National Hospital Discharge Survey
http://www.cdc.gov/nchs/about/major/hdasd/nhdsdes.htm

Approximate Date of Next Update

Unknown

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