A report by the National Center for Health Statistics reveals that circumcisions of newborn boys in U.S. hospitals have dropped 6 percentage points over the last 30 years, from 64.5 percent in 1979 to 58.3 percent in 2010. The sharpest declines took place in Western states, Reuters reports. The federal analysis shows that circumcision rates have risen and fallen over the years, possibly in response to changing advice from the American Academy of Pediatrics. Last year the academy revised its policy on circumcision, saying that the benefits of circumcision outweigh the risks.
The analysis didn't include circumcisions performed outside the hospital in religious ceremonies, for example, or those performed when a boy is older.
One factor that may account for the overall decline in hospital-based circumcisions may be the decreased time babies now spend in the hospital, says pediatrician Douglas Diekema of the Treuman Katz Center for Pediatric Bioethics at Seattle Children's Research Institute.
"Often they're going home within 24 hours, so in some places, these procedures are increasingly being done by the pediatrician during the follow-up period in the doctor's office or clinic as opposed to the hospital," Diekema says.
The steep decline in the West may be related to higher rates of immigrants from countries where circumcision is less common, he says.
Recent research suggests circumcision does "help prevent certain kinds of infections," says pediatrics group president Thomas McInerny. In particular, "there is some evidence that the cells that make up the inner surface of the foreskin may provide an optimal target for the HIV virus." Research also shows that circumcised males have a lower risk of urinary tract infections and penile cancer, he says.
Complications associated with circumcisions are rare, and include minor bleeding, local infection and pain, says Diekema, but those factors can be easily treated.
A cost study reported last year in the Archives of Pediatrics & Adolescent Medicine said falling infant circumcision rates in the U.S. could end up costing the country billions of health care dollars when men and their female partners develop AIDS and other sexually transmitted infections and cancers that could have been prevented.
The health benefits evidence was not so strong that the AAP felt compelled to recommend routine circumcision for all newborn boys, says McInerny. "We wanted to give parents the information as we understand it from the research and let them make the decision."
Image: Newborn boy, via Shutterstock