This is the full text. Good news that the rate is in free fall, frightening and sickening that 6.5 million innocent American boys were mutilated between 2006 and 2009. Gloria
By Mitchel L. Zoler
Elsevier Global Medical News
http://www.imng.com
Breaking News
VIENNA (EGMN) – Circumcision rates for newborn boys in the United States
dropped steadily and markedly over the past 4 years, based on the largest
review of U.S. rates ever done.
Circumcision rates fell from 56% in 2006 to 33% in 2009.
The review, which included more than 6.5 million U.S. newborn boys during
the period, also showed that adverse event rates following newborn male
circumcision were “extremely low,” and that the most common adverse events
were “mild and easily corrected,” Charbel El Bcheraoui, Ph.D., said at the
18th International AIDS Conference.
“Severe male circumcision-related adverse events are extremely rare,” said
Dr. El Bcheraoui, an epidemic intelligence service officer in the division
of HIV/AIDS prevention at the Centers for Disease Control and Prevention.
The dramatic decline in circumcision rates during 2006-2009 continued a
trend that began in the United States earlier in the decade, although the
fall appeared to accelerate recently, he said. He attributed the drop to a
1999 statement by the American Academy of Pediatrics that said existing data
were not sufficient to recommend routine newborn male circumcision
(Pediatrics 1999;103:686-93).
Another factor may be that following the AAP statement, several states
withdrew Medicaid coverage of newborn male circumcision, Dr. El Bcheraoui
said. An earlier report by him and his CDC associates documented that during
1979-2006, the U.S. newborn male circumcision rate was relatively stable,
with an average rate of 61%.
The recent fall in U.S. circumcision rates coincided with reports from three
African-based randomized controlled trials in 2005-2007 that showed
circumcised men had a 50%-70% reduced risk for acquiring HIV infection,
compared with uncircumcised men. These findings led the World Health
Organization and the Joint United Nations Programme on HIV/AIDS to recommend
male circumcision as an important intervention to reduce the risk for
heterosexually acquired HIV infection in 2007. The CDC and AAP are now
independently interpreting the application of these recent findings on HIV
transmission to the United States based on U.S. prevalence rates of HIV and
circumcision, he said.
The new study also analyzed 90-day outcome data on 258,189 boys and men aged
1 or older who underwent circumcision during 2006-2009, and found that
adverse events occurred much more frequently in this age group, “an
important new finding,” Dr. El Bcheraoui said.
His study used data from the largest U.S. consolidator of electronic health
care reimbursement claims, which included data on 117 million unique U.S.
patients annually undergoing short hospital stays, and data from more than
800,000 unique U.S. health care providers. In this database, 6,571,500
newborn boys underwent circumcision during 2006-2009. To estimate the
incidence of circumcision-associated adverse events, the researchers tallied
the rate of any of 41 different ICD-9 and CPT codes that could be such
events during the 90 days following circumcision. They also compared these
rates in 18,330 infants circumcised within the first month of life with a
matched set of uncircumcised infants.
The data showed that the rates for a range of adverse events, such as
mishaps, correctional procedures, and infections were substantially lower in
boys less than 1 year old, compared with boys aged 1-9 years, and with boys
and men aged 10 years or older. For example, mishaps occurred in none of the
boys aged less than 1 year or aged 1-9 years, but in 158/100,000 boys and
men aged 10 years or older. The rate of correctional procedures was
58/100,000; 2,544/100,000; and 1,709/100,000 in the three age groups,
respectively. Infections occurred at a rate of 154/100,000; 5,664/100,000;
and 4,527/100,000 in the three age groups.
The case-control analysis identified only two types of adverse events that
were more common in circumcised newborn boys, compared with matched
uncircumcised infants: repair for incomplete circumcision, and lysis or
excision of penile adhesions. All other adverse events tallied either
similar rates among the cases and controls, or were significantly more
common among the controls.
“This is the largest study to examine the incidence of male circumcision
adverse events to date. It is highly representative [for the United States],
with a large data set” and with a large number of potential adverse events
tracked, Dr. El Bcheraoui said. One of the strengths of the study was its
longitudinal design, which followed subjects for 90 days following
circumcision.
Dr. El Bcheraoui and his associates said they had no disclosures.
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