A Drop in Circumcision Rates Could Mean Billions in Healthcare Costs

More parents deciding against the procedure could trigger a rise in sexually transmitted disease rates.

While circumcision is a personal decision, it also has public health implications, as a study points out. Declining circumcision rates could mean a spike in healthcare costs. (Photo: Diane Macdonald/Getty Images)

Aug 22, 2012
Jeannine Stein, a California native, wrote about health for the Los Angeles Times. In her pursuit of a healthy lifestyle she has taken countless fitness classes, hiked in Nepal and got in a boxing ring.

To snip or not to snip: that is the question facing parents who must decide whether or not to circumcise their sons. Here’s an argument in favor: If more people opt not to circumcise it could add an extra $4.4 billion in U.S. healthcare costs over the next 10 years.

This isn’t just about the money—the costs are indicative of having to treat more cases of HIV and AIDS, cervical and penile cancers and herpes. Previous studies have shown a link between higher circumcision rates and lower incidence of sexually transmitted diseases.

A study released this week in the Archives of Pediatrics and Adolescent Medicine used a computer-based economic model to predict how costs and infections could increase along with a 10 percent circumcision rate, the average rate in Europe.

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To build the model, researchers consulted studies and databases on sexually transmitted disease infections. They also  considered drug treatment costs, along with doctor visits and hospital care. Overall, each circumcision not done would translate into $313 extra in illness-related costs.

It would also mean 12 percent more men infected with HIV, 29 percent more men infected with the human papillomavirus, and a 211 percent increase in infant male urinary tract infections.

Let’s not forget about the female partners of these men. They’d see a 50 percent rise in bacterial vaginosis and trichomoniasis cases and an 18 percent increase in new high-risk HPV infections, which is associated with cervical cancer.

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“Our economic evidence is backing up what our medical evidence has already shown to be perfectly clear,” senior author Aaron Tobian of Johns Hopkins University School of Medicine said in a news release. “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.”

Obviously not everyone agrees with Tobian’s position, which may explain why male circumcision rates have declined in the U.S. over the years, becoming a polarizing issue among parents along the way. During the 1970s and 1980s rates were at about 79 percent in the U.S., but currently that number is at about 55 percent.

The authors note that state Medicaid cuts could be having an influence, since 18 states have now stopped footing the bill for circumcisions.

“State governments need to start recognizing the medical benefits as well as the cost savings from providing insurance coverage for infant male circumcision,” Tobian said.

Where do you stand on the circumcision issue? Let us know in the comments.

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