No Longer Routine; Circumcision Rates Decline Nationally, Albeit More Slowly in Midwest

Recent research in South Africa suggests male circumcision may reduce the transmission of HIV and other STDs. In the United States, circumcision rates declined by 7.2 percent between 2001 and 2003, reaching a 50-year low of 55.9 percent, according to CDC. Even in the Midwest, which has the nation's highest rate at 77.8 percent, the procedure's popularity is in decline.

The decline may reflect the lack of medical reasons for circumcision and an increase in the population of immigrants from countries where the procedure is not performed, say health care professionals. The American Academy of Pediatrics (AAP) and other prominent medical associations do not recommend the procedure.

"I would say that all the pediatricians in town go with the academy's party line: This is a cosmetic surgery. There is no medical reason to do it," said Dr. Nancy Hansen, department of pediatrics chairperson at Riverside Methodist Hospital in Columbus. Often, cultural reasons apply. "They don't want their boys to look funny in the locker room," said Hansen.

Hygiene "really isn't a good reason to justify circumcision," said Dr. JoAnn Rohyans of Olentangy Pediatrics and spokesperson for the Ohio Chapter of AAP.

"Studies have shown that cultures practicing circumcision are less likely to have HIV," said Dr. Michael Para, an infectious-disease specialist at Ohio State University Medical Center. "If we can say for sure that circumcision reduces the risk of HIV, then suddenly there clearly is a medical benefit."

Currently, however, evidence on HIV and circumcision is not strong enough to challenge medical society policies. The American Medical Association says that decreases in urinary-tract infections in infants and penile cancer among adults are not significant enough to justify circumcision.

Back to other news for January 20, 2006