Falling circumcision rates could raise cost of care

August 29, 2012

A team of disease experts and health economists at Johns Hopkins University, Baltimore warns that steadily declining rates of U.S. infant male circumcision could add more than $4.4 billion in avoidable health care costs if rates over the next decade drop to levels now seen in Europe.

A team of disease experts and health economists at Johns Hopkins University, Baltimore warns that steadily declining rates of U.S. infant male circumcision could add more than $4.4 billion in avoidable health care costs if rates over the next decade drop to levels now seen in Europe.

In a report published online in Archives of Pediatrics & Adolescent Medicine (Aug. 20, 2012), the authors said the added expense stems from new cases and higher rates of sexually transmitted infections and related cancers among uncircumcised men and their female partners.

Senior author Aaron Tobian, MD, PhD, said that roughly 55% of the 2 million males born each year in the United States are circumcised, a decline from a high of 79% in the 1970s and ‘80s. Rates in Europe average only 10%, and in Denmark, only 1.6%.

"Our economic evidence is backing up what our medical evidence has already shown to be perfectly clear," said Dr. Tobian. "There are health benefits to infant male circumcision in guarding against illness and disease, and declining male circumcision rates come at a severe price, not just in human suffering, but in billions of health care dollars as well."

The 20-year decline in the number of American males circumcised at birth has already cost the nation upwards of $2 billion, Dr. Tobian said.

The authors’ analysis showed that, on average, each male circumcision passed over and not performed leads to $313 more in illness-related expenses. In addition, if U.S. male circumcision rates among men born in the same year dropped to European rates, there would be an expected 12% increase in men infected with HIV; 29% more men infected with human papillomavirus; a 19% increase in men infected with herpes simplex virus; and a 211% jump in the number of infant male urinary tract infections.

Dr. Tobian said state funding cuts in Medicaid have substantially reduced numbers of U.S. infant male circumcisions, noting that 18 states have stopped paying for the procedure.

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