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Recent statistical evidence from the
Center for Disease Control (CDC) (see figures below) indicates
that in the United States (U.S.) newborn circumcisions
among non-immigrant boys have increased over the past
2 decades. There are over 100 million circumcised U.S.
boys and men, encompassing about 70% of the total male
population in this country. Currently 65% of U.S. baby
boys are being circumcised in the hospital as newborns,
and at least another 5 - 10% of males will be circumcised
later for foreskin problems and cultural reasons.
The CDC found that the total U.S. newborn
circumcision rate rose very slightly (from 64% to 65%)
over the two decade period, from 1979-1999, but the breakdown
of these statistics is revealing. There have been increases
in circumcision among blacks (from 56 to 64%) and in newborns
from the Midwest (from 74 to 81%) and the South (from
56 to 61%), areas of the country with the fewest new immigrants.
In specific communities very high circumcision rates are
being reported: 84% in Atlanta, Georgia, 85% in Houston,
Texas, and 92% in a Wisconsin community served by a pediatrician
opposed to circumcision. In the Georgia survey the medical
record face sheet reflected only 84% of the circumcisions
actually done (O'brien, Southern Med J 1995); prevalence
would have appeared to be only 70% using the face sheet
diagnosis alone, as the CDC does suggesting that the CDC
figures underestimate the true prevalence of newborn circumcision.
In view of these specific high and increasing
circumcision rates why have the overall percentages not
increased more? The answer lies on the West Coast, particularly
in California, where the circumcision rate fell from 64%
in 1979 to 37% in 1999. In 1979 the majority of births
in California was among non-immigrant whites. By 1999
Hispanic infants constituted the largest group (46.5%
of newborns); only 31.2% were non-immigrant whites and
6.2% were black; most of the rest were Asians. Hispanics
and Asian immigrants rarely have their newborn boys circumcised.
Since these 2 ethnic groups make up over 56% of California
newborns, even if 100% of non-immigrant white and black
infants were circumcised, the overall prevalence of circumcision
in California would be under 40%, an explanation for the
37% Western circumcision rate reported by the CDC. In
the East there is a similar though less marked effect,
since there are proportionally fewer immigrants.
The rising non-immigrant circumcision
rate in the U.S. probably represents growing public awareness
of the compelling published medical evidence favoring
circumcision. Since the 1980's more than 15 separate studies
have shown that uncircumcised male infants are about 10
times more likely to get serious kidney infections in
the first year of life. Uncircumcised men are 22 times
more likely to get devastating, invasive penile cancer.
Over the past 15 years evidence, mainly from Africa, has
shown that uncircumcised men are 2 - 5 times as likely
to get human immunodeficiency virus (HIV) infection on
exposure. Public response in Africa has resulted in a
call for adult male circumcision. In the face of this
increasing proof of the health benefits of circumcision,
it seems likely that the newborn circumcision rate in
the U.S. will continue to increase.
For details, documentation and references
of the recent CDC data confirming rising circumcision
and for medical publications regarding circumcision logon
to www.medicirc.com or www.medicirc.org.
The CDC statistics can be found at the
Center for Health Statistics' Web site. Scroll down
to see Figure
1 and Table 1, and Figure
2 and Table 2.