Whether male babies undergo procedure has become a personal decision between families and their doctors, experts say
WebMD News from HealthDay
By Steven Reinberg
HealthDay Reporter
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 said.
"The benefit of circumcision outweighs the very small risk, and therefore it is recommended, but it is not strongly recommended," McInerny explained.
source : U.S. Circumcision Rates Drop by 10 Percent: CDC
