U.S. Neonatal Circumcision Rates Drop Over 10 Years

Declining Circumcision Rates Raise Concerns

A new study by Johns Hopkins Medicine and the Johns Hopkins Bloomberg School of Public Health reveals that neonatal male circumcision (NMC) rates in the U.S. have dropped nearly 5% over the past decade.

Despite strong recommendations from leading health organizations, including the World Health Organization (WHO), American Academy of Pediatrics (AAP), and the CDC, the procedure’s prevalence fell from 54.1% in 2012 to 49.3% in 2022, according to findings published in JAMA Pediatrics.

“We reviewed over 1.5 million U.S. hospitalizations of male neonates, ages 0 to 28 days, during the period 2012 to 2022, and found that the overall prevalence of hospitalizations where a neonatal male circumcision was performed decreased significantly, from 54.1% to 49.3%. Decreases were observed across most patient and hospital subgroups, including whites – a group with traditionally high circumcision rates – where circumcisions dropped 5.3% over the decade studied.” 

• Aaron Tobian, M.D., Ph.D., study co-senior author, professor of pathology, Johns Hopkins University School of Medicine

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Researchers analyzed data from over 1.5 million hospitalizations of newborn males between 0-28 days old using the Kids’ Inpatient Database. Significant declines were observed among white neonates, dropping from 65.3% to 60.0%. Rates among Black (64.9% to 66.1%) and Hispanic infants (21.2% to 21.0%) remained steady, while decreases were also seen in Asian/Pacific Islanders and Native Americans.

Barriers Driving the Downward Trend

Study co-author Dr. Aaron Tobian, professor of pathology at Johns Hopkins, cited multiple factors for the decline:

• Parental distrust of medical advice is driven by growing skepticism toward healthcare recommendations.
• Cultural demographics, with Hispanics representing the fastest-growing population group in the U.S., have historically shown lower circumcision rates.
• Financial barriers, as 17 states stopped Medicaid coverage for routine circumcision by 2011, reducing access for lower-income families.

Interestingly, newborns from higher-income families and those with private insurance initially had the highest circumcision rates but also experienced the largest declines over the study period.

Public Health Implications 

Circumcision has been associated with a lower risk of urinary tract infections, penile inflammation, and reduced transmission of sexually transmitted infections, including HIV, genital herpes, and HPV, which are linked to several cancers.

Health experts caution that declining rates may affect long-term public health outcomes, especially in populations at higher risk for these conditions.

The study underscores the importance of addressing cultural perceptions, improving patient education, and ensuring equitable access to this preventive procedure. With changing population dynamics and healthcare policies, clinicians must engage families with accurate, evidence-based information to guide decision-making.

Source:

Johns Hopkins Medicine