Decline in circumcisions could cost billions
Declining circumcision rates in the United States could wind up costing billions later, researchers warn.
August 21st, 2012
10:15 AM ET

Decline in circumcisions could cost billions

As the number of American parents increasingly leave their baby boys uncircumcised, HIV and other sexually transmitted disease rates are likely to climb, according to researchers from Johns Hopkins University, and the costs associated with those diseases could reach into the billions.

"The medical benefits of male circumcision are quite clear," said Dr. Aaron Tobian, an assistant professor of pathology at Johns Hopkins and lead author of the study published Monday in the Archives of Pediatric and Adolescent Medicine. "But while the medical evidence has been increasingly more positive, male circumcision rates in the U.S. have been decreasing."

Specifically, he says, circumcision rates had been fairly stable in the 1970s, at about 79%. By 1999, he says less than 63% of boys had the procedure, and by 2010, the rate had dropped to 55%.

What's more, state-run and private insurance companies in at least 18 states have dropped coverage for male circumcision - a procedure that can cost between $250 and $300 without insurance coverage, causing even more parents to pass on the procedure for male infants.

Jews, Muslims slam German circumcision ruling as assault on religion

"If circumcision rates decrease to 10% - the levels seen in Europe where insurance coverage is limited - the direct medical costs associated with that drop could exceed $4 billion," said Tobian.

That added cost, he says, is largely from an increase in HIV infections and human papillomavirus (HPV)-related cancers he believes would result from the drop in circumcisions.

Should teens make circumcision decision?

"Three randomized trials have demonstrated that male circumcision decreases HIV, male herpes, and HPV - the virus that causes cervical and penile cancer," Tobian said. "As male circumcision rates increase, you decrease HIV acquisition among men. Later down the road, because fewer men are infected, you'd have less transmission."

As a result of this study, Tobian says he's calling on the American Academy of Pediatrics, other advocacy groups and insurance companies to pave the way for more circumcisions.

"We should eliminate all of the current barriers that are in the way of individuals receiving this procedure," he said. "Once we do that, families can discuss the risks and the benefits of having the procedure with their physicians, and then can make an informed decision."

Circumcising our son: How do we decide?

The debate over circumcision has been ongoing for years. Critics of the procedure maintain it is not medically necessary, carries the risk of complications and pain and that foreskins are a part of the natural body that help protect the penis.

The American Academy of Pediatrics is expected to release an updated position paper supporting the health benefits of male circumcision by the end of this month.

California governor signs law preventing male circumcision ban

soundoff (299 Responses)
  1. anon

    Yet another "sponsored" study. If the foreskin wasn't needed, wouldn't it have vanished gradually... much longer tail did.

    August 22, 2012 at 02:32 | Report abuse | Reply
    • Dan

      Didn't know they lobbied for this too...

      August 22, 2012 at 02:44 | Report abuse |
    • jorge

      evolution happens over millions of years. the tail disappeared much earlier on our common ancestor. plus, not everything without use disappears. for example, humans have an appendix, which scientifically has been proven to have no use, thereby becoming a vestigial organ. it's possible that the foreskin will indeed become vestigial or disappear as well.

      August 22, 2012 at 02:52 | Report abuse |
    • revolting peasant

      Jorge - just a side note. The appendix is now believed to be a repository for beneficial gut flora.

      August 22, 2012 at 03:26 | Report abuse |
    • Ned

      You're still here.

      August 22, 2012 at 03:56 | Report abuse |
    • edofmtl

      Have you ever heard of the appendix? What a poor argument. Most arguments against science are poor arguments.

      August 22, 2012 at 07:31 | Report abuse |
    • babaelf


      August 22, 2012 at 10:28 | Report abuse |
    • Ben

      Just because something is "not needed" does not mean it will disappear. Something will only disappear if not possessing it confers a selective advantage. To those that dispute these study results...I have one question: "Have you read the source studies that this study is based on?" If not, you are as guilty of "parroting" as the doctors you slam.

      August 22, 2012 at 11:19 | Report abuse |
    • UFC iTard

      What kind of idiot compares the function of a foreskin to eyelids?

      August 22, 2012 at 13:06 | Report abuse |
    • Milton Platt

      Without a link to the report so we can see the actual study, this article is almost worthless. The american media is noted for rolling out controversial or inflammatory articles just to up the readership. There may or may not be validity to the research. No way to know here. But I do know I won't be taking medical advice about my family from a journalist for CNN.

      August 22, 2012 at 13:13 | Report abuse |
    • jdk28

      Its now less necessary because we wear pants. Simple.

      August 22, 2012 at 13:44 | Report abuse |
    • pat

      The viruses that cause disease evolve faster than humans.

      August 22, 2012 at 14:18 | Report abuse |
  2. Victoria

    Just teach your son to wash his penis. We're talking about mutilation of babie's genitals here, it's not necessary. Practice good hygiene, and you're fine.

    August 22, 2012 at 02:34 | Report abuse | Reply
    • Victor

      Gee, Victoria, after years of men trying to tell women what to do with their bodies, I guess you figured it was our turn. Feel better now? My parents had it done to me, and I had it done to my 2 boys. It's an extremely minor procedure, and it simplifies things considerably. Take your 'mutilation' comments somewhere else.

      August 22, 2012 at 02:58 | Report abuse |
    • Lou Cypher

      We should build ovens for people that practice infant genital mutilation.

      August 22, 2012 at 04:57 | Report abuse |
    • jim d.

      Just teach your son to wash his penis. We're talking about mutilation of babie's genitals here, it's not necessary. Practice good hygiene, and you're fine.

      wow! you spelled "hygiene" ( a commonly misspelled word) correctly but have an "apostrophe catastrophe" in "babie's"

      August 22, 2012 at 07:32 | Report abuse |
    • DrBob57

      Victor – You don't know what you're missing. Literally.

      August 22, 2012 at 17:04 | Report abuse |
  3. Lee

    It's mutilation... plain and simple...

    and this study is out of line with others

    leave it be and teach your boy to wash properly.

    There will be some emotional responses here from people who had it, and want their boys to "look" the same...

    August 22, 2012 at 02:40 | Report abuse | Reply
    • jorge

      Pretty sure I'd trust the World Health Organization rather than your personal belief...

      August 22, 2012 at 02:59 | Report abuse |
    • Ned

      Words mean something and making this minor procedure equal to horrific disfiguration cheapens the very real pain and suffering of individuals who have been truly mutilated by having their noses hacked off, eyes gouged out, ears ripped off, acid thrown on their faces, and a whole lot worse. You owe the victims of real mutilation an apology for minimizing their suffering by suggesting it is the same as a minor removal of skin resulting in very real health beneftis. If you don't like the procedure and the people who practice it then maybe you should consider the possibility that it is your own cultural intollerance and hatred of an ethnic group that's the real problem. Why else would you minimize a term with such a history of real pain, real hate, and real lifetime long suffering?

      August 22, 2012 at 03:55 | Report abuse |
    • James

      The World Health Organization can kiss my butt

      August 22, 2012 at 05:05 | Report abuse |
    • James

      Really Ned, get a grip. or maybe they cut off so much you can't get a grip....

      August 22, 2012 at 05:06 | Report abuse |
    • Steve

      After researching some of their statistical methodology, I find ALL of the WHO's information very suspect.

      August 22, 2012 at 05:13 | Report abuse |
    • cosmor

      Your nuts...

      August 22, 2012 at 07:30 | Report abuse |
  4. Doctor Who?

    "Doctors" and medical establishments make enormous sums of money in fees for mutilating male genitalia. These so-called "studies" are simply manufactured lies to support their point of view. For every study quoted there is another that shows the exact opposite results.

    Maybe we should all have our lips removed at birth. It would save everyone from needing to brush their teeth.

    .... hmm now how could we solve the increase in testicular cancer rates? or broken arms, etc etc.

    August 22, 2012 at 02:48 | Report abuse | Reply
  5. sayitstr8

    yes, and so is pierced ears. all mutilation. get all those women mutilators lined up against wall and plug up their ear holes, nose holes, belly holes, etc. and the guys, too. plug up the mutilators, I say. or, if this sounds absurd, maybe more than this is in this mass debate.

    August 22, 2012 at 02:53 | Report abuse | Reply
    • Lisa

      Difference? Those are ADULTS making body modifications. A minor can't walk into a tattoo or piercing parlor and expect to get a nice "Mom" tat on their bicep.

      August 22, 2012 at 10:35 | Report abuse |
  6. Victor

    I'll lay you money these people calling it 'mutilation' are also convinced that childhood immunization causes autism. Some people will believe anything if they want to.

    August 22, 2012 at 03:00 | Report abuse | Reply
    • Dr. Z

      amen brother

      August 22, 2012 at 06:23 | Report abuse |
    • veep

      The two groups aren't even remotely related.

      August 22, 2012 at 07:30 | Report abuse |
    • Alexa

      You are wrong, sir. I chose not to cause my son unnecessary pain in the pursuit of dubious health benefits and left him intact. Should he decide to go through the procedure later in life, I will support him in every way I can. In the meantime, he WILL go through all of the NECESSARY pain of receiving his immunizations on the pediatrician recommended schedule. Please do not make assumptions lumping legitimate concerns in with ill-informed pseudoscience.

      August 22, 2012 at 11:51 | Report abuse |
    • CNNNN

      False. I am an intactivist and keep my children whole – I also believe in vaccines and herd immunity. There are some derpy anti-vaccine morons pervasive in all kinds of movements. Do not confuse those of us concerned with bodily autonomy of minors with morons that believe all kinds of bogus anti-vaccine 'information.'

      August 22, 2012 at 12:08 | Report abuse |
  7. Anonymous

    I'm sure if we removed the penis entirely, we could reduce the STD rate even further! It's not needed anymore anyway, now that we have in vitro fertilization.

    August 22, 2012 at 03:05 | Report abuse | Reply
    • JDiva79

      Good point!

      August 22, 2012 at 09:49 | Report abuse |
  8. Jan

    My posts don't seem to be going through. You'd think CNN would ease off the word filter for articles like this.

    August 22, 2012 at 03:12 | Report abuse | Reply
    • Jan

      I'll try to rephrase it...

      The "benefits" become irrelevant if the guy is taught to practice safe ___ and monogamy. The downsides of loss of sen.sation and loss of the right to autonomy over your own body and to choose your own rel.igion when you're old enough far outweighs any negligible benefit.

      If guys want to opt for that procedure themselves when they're adults, that's their choice, but that's not a choice which should be made for them as babies except in the rare cases of medical necessity (ie if they're in extreme pain, or they have a tumour etc).

      August 22, 2012 at 03:14 | Report abuse |
    • Dubhly

      gotta love it, " if the guy is taught" lol yep its always the guy who screws around on the woman. Hate to break it to you but i have had a couple of the woman in the past who screwed around on me, humans are humans. So if the GUY is taught to only have sex with their partner, but their partner is going out screwing around on them, and they have not been nipped they are at a higher chance of contracting several various ailments. SOOOO...in reality " if the guy is taught" means nothing at all.

      August 22, 2012 at 08:50 | Report abuse |
    • Lee

      Dubhly, This article is about men. Women also need safe sex and preferably monogamy.

      August 22, 2012 at 10:59 | Report abuse |
  9. Andy

    If cutting a piece of a penis off isn't mutilation, what is?

    August 22, 2012 at 03:33 | Report abuse | Reply

    how bad can it be...It is only byte size right ?

    August 22, 2012 at 03:53 | Report abuse | Reply
  11. jack johnson

    It started with controling the female body, now it is baby boys. Fix the jobs, and buget first then start trying to control peoples's bodies.

    August 22, 2012 at 04:29 | Report abuse | Reply
  12. James

    I am offended that at birth they sliced my penis. You should not butcher your child at birth. They have the right to the heightened sensetivity that foreskin gives.

    August 22, 2012 at 04:43 | Report abuse | Reply
  13. Jimbojoe

    Cleaning oneself is not nearly as hard or time-consuming as flossing or even brushing your teeth. You pull back the skin, rinse thoroughly, and done. When you shower, do you half-@ss it and forget to wipe your crack? no. These traditions are stupid.

    August 22, 2012 at 05:01 | Report abuse | Reply
  14. Jimbojoe

    You always hear of dudes using moisturizer because it's rough on the head to have it rubbed vigorously like that. I haven't been cut up so it's always good to go. The skin is protection, helps build stamina, and has nerve endings that all these sorry suckers are missing out on. Cutting parts off your penis is stupid and any man with self-respect and a choice should lay-out anyone suggesting it. Plus it's a conversation starter. I told some chicks I knew that I never had that done, and they all wanted a look-see 😉

    August 22, 2012 at 05:08 | Report abuse | Reply
    • James

      You're funny

      August 22, 2012 at 05:42 | Report abuse |
    • Stan

      Odd, I'd have thought your Mom would have already known about this when you offered to show it to her.

      August 22, 2012 at 15:24 | Report abuse |
  15. unschoolparents

    Here's some more ways we could preemptively reduce future medical costs: 1) give every infant an appendectomy, 2) give every infant a tonsillectomy, 3) sterilize all infants, 4) universal gastric bypasses, 5) since women spend almost twice as much on health care as men do... I guess it's just best if we perform gender reassignment surgery on all female infants.... The possibilities are endless.

    August 22, 2012 at 05:15 | Report abuse | Reply
  16. Jimbojoe

    A thousand years ago some warmongering holy-roller goes around cutting off penises of his enemies, putting them in a bag, using that as a dowry, and now it's been the "cool" thing to do for a millennia. Learn to think for yourselves, sheeple!

    August 22, 2012 at 05:21 | Report abuse | Reply
    • Meme

      What are you going on about?

      August 22, 2012 at 13:18 | Report abuse |
  17. James

    Want to hear some real BS, not only did i get my penis mutilated but my parents let a dentist do what he called preventative dentistry, ya know what that is he drilled and filled all my back teeth, they didn't have cavities, it was preventative. Now, all of my teeth are fine except all my back teeth got pulled because these metal mercury fillings washed out and ruined my back teeth, no fillings anywhere else....

    August 22, 2012 at 05:47 | Report abuse | Reply
    • ladydi

      WOW – your parents should be nominated for Parents of the Year...........NOT

      August 22, 2012 at 07:39 | Report abuse |
  18. boatvolt

    In a tough job market, this will result in more unemployed Mohels. Admittedly, their pay is not very good, but the tips are great...

    August 22, 2012 at 06:01 | Report abuse | Reply
  19. Dan W

    Is money really the issue, or is it that American Christians want to be the new chosen people?

    August 22, 2012 at 06:03 | Report abuse | Reply
  20. Wildone

    I remember when real doctors did TV commercials promoting cigarettes. Methinks "Dr. Mangle-a" has an agenda.

    August 22, 2012 at 06:23 | Report abuse | Reply
  21. miscreantsall

    Victor………..do you have any IQ at all?

    Your comments are very ignorant!!

    August 22, 2012 at 06:24 | Report abuse | Reply
  22. Curzen

    I didn't know we prefer penile mutilation to marginally lower the risk of infection instead of teaching young adults to be responsible and use condoms which tend to offer a far higher rate of protection. Oh and learn to wash yourself, we aren't living in medieval or neolithic times where soap and clean water are a luxury. Genital mutilation of minors needs to be persecuted regardless of the child's gender.

    August 22, 2012 at 06:25 | Report abuse | Reply
    • trombonebiker

      This isn't genital mutilation. You don't know much do you.

      August 22, 2012 at 07:20 | Report abuse |
  23. Ron

    In this land of free speech, it is sad to see Intelligent discourse disappearing. How can a democracy work in these times? A rational exchange of ideas cannot occur among people unless they are willing to discuss, listen and consider different points of view. Instead, any new topic becomes a magnet for malicious commentators to spread their bigoted, mean-spirited vitriol.

    August 22, 2012 at 06:25 | Report abuse | Reply
  24. Wildone

    Baby's first words: "Don't touch my 'junk'!"

    August 22, 2012 at 06:39 | Report abuse | Reply
  25. The Duke

    What an incredible headline. The consequences are expressed not in human suffering, but in dollar signs.

    August 22, 2012 at 06:55 | Report abuse | Reply
  26. Chris

    Increased HIV rates? You get HIV from having sex with a person who already has HIV (or by using dirty needles or blood transfusions, which have nothing to do with foreskin). This is ridiculous.

    August 22, 2012 at 06:57 | Report abuse | Reply
    • steve

      You don't *always* get HIV from having sex with a carrier, but having foreskin intact makes a man more likely to contract it.

      August 22, 2012 at 12:57 | Report abuse |
  27. Mrs. Havisham


    August 22, 2012 at 07:01 | Report abuse | Reply
  28. SDG

    This is retarded-ly dumb on behalf of the parents to NOT perform this very basic procedure. There's tons of benefits and no real reason not to. I fear for women in the next generations to have to deal with the wide spread of diseases & plague like outbreaks because some lazy fool didn't wash himself. Yes, we are talking about MEN who do not wash their hands after going to the bathroom.

    August 22, 2012 at 07:15 | Report abuse | Reply
    • Milton Platt

      Be so kind as to list the "tons" of benifits.......

      August 22, 2012 at 13:16 | Report abuse |
    • NickZadick

      reasons not to?? how about it looks horrid!! drastically decreased sensation of the tip ?? like I commented below... how about asking women to slice off their labias?? I'm sure they will find absolutely nothing wrong with that like you!!

      August 22, 2012 at 16:19 | Report abuse |
  29. Sick and tired

    Oiy, ve're gonna lose some bizness. Ve need to think of sum udder profitable medical skeme.

    August 22, 2012 at 07:20 | Report abuse | Reply
  30. Thomas Henley

    The Doctors of the world would like you to know that failing to pay them 10 billion a year to mutilate infants could result in you having to pay 5 billion a year to treat un-mutilated infants engaged in highly risking sex with a specific African Tribe in Africa suffering a very potent form of AIDs that in extreme cases can infect an infant engaging in risky sex with out a condom!

    Your net savings of 5 billion is nothing you should consider let alone the fact that most infants don't engage in sex with rural and remote African Tribes.

    This study brought to you by John Hopkins run by the Russel Trust and Russel Family, purveyors of opium since 1824 and founders of the Skull and Bones 322...paying off and intimidating people like the author of this piece since 1832!

    August 22, 2012 at 07:53 | Report abuse | Reply
  31. F Hittle

    What gets me, more than anything, is that the same reasons people give for mutilating their sons are the same reasons parents in other countries and even in the U.S. give for mutilating their daughters. If you wouldn't do it to your little girl, why on earth would you do it to your little boy?

    August 22, 2012 at 08:59 | Report abuse | Reply
  32. Alex Brands

    In a related story, toenail fungus could be eradicated if everyone had their baby's toenails removed. Seriously, how horrified would people be at that?

    August 22, 2012 at 09:08 | Report abuse | Reply
  33. K

    However, we're cleaner than Europeans. A little hygiene goes a long way.

    August 22, 2012 at 09:34 | Report abuse | Reply
  34. Zaira @ LLLN

    b/c 80-90% circ rates before really prevented HIV from taking hold in the US, right? *headdesk*

    August 22, 2012 at 09:42 | Report abuse | Reply
    • Jim

      Don't bring logic into this. You're going to confuse people.

      August 22, 2012 at 11:34 | Report abuse |
  35. John M.

    STOP IT! This is an emotional issue, folks, so please stop trying to confuse us with facts based on scientific research. We have a right to go with our preconceived notions. And yes, we want to engage in name-calling and demonizing, because that is what gives us the warm feeling all over. So stop interjecting silly things like facts into the discussion.

    August 22, 2012 at 10:43 | Report abuse | Reply
  36. Lee

    What this article is saying that this procedure will enable our boys to have sex more freely. Perhaps we should teach our sons to be responsible about sex?

    August 22, 2012 at 10:53 | Report abuse | Reply
  37. Jim

    So the natural state of a man is unhealthy? Who do you believe, the doctors or 250,000 years of evolution?

    August 22, 2012 at 11:32 | Report abuse | Reply
    • Bill

      I am going to go with Doctors, for 249,900 years life expectancy for the human race was on average 35 years old. (CDC (1999). "Ten great public health achievements—United States, 1900–1999") in the past 100 years life expectancy has gone from 35 years old to 73 years old. (Public health measures are credited with much of the recent increase in life expectancy. During the 20th century, the average lifespan in the United States increased by more than 30 years, of which 25 years can be attributed to advances in public health). Just some facts for you, not my opinion.

      August 22, 2012 at 14:48 | Report abuse |
  38. Jeff

    I'll agree as soon as I stop seeing babies with earrings.

    August 22, 2012 at 12:15 | Report abuse | Reply
  39. Pat

    Over the last 8,000 years of evolution, the foreskin is still there. However, I prefer its removal.

    August 22, 2012 at 12:28 | Report abuse | Reply
  40. Gerry

    Man is devolving. HIV and other disease transmission are a result of the de-evolution of man's mind which affect the body.

    August 22, 2012 at 12:30 | Report abuse | Reply
  41. steve

    Just wait until they get infections and need to be cut as an adult... a relative had this scenario and was laid up for 3 weeks.

    August 22, 2012 at 12:54 | Report abuse | Reply
  42. gumbojones

    Genital mutilation is wrong, on men or women. If it's so wonderful let the individual decide when they are grown. Mutilating your children should be a crime and punishable by law, no matter how you do it or for what reasons. Genital mutilation needs to be outlawed, now, not later.

    August 22, 2012 at 12:58 | Report abuse | Reply
  43. pillsville piper

    those of you who still believe the "theory" of evolution are relying on failed science. there is still no proof that we evolved, and no evidence that we are presently evolving, neither man nor animals, and i draw a distinction between the two.

    August 22, 2012 at 13:22 | Report abuse | Reply
  44. double b

    the medical reasons are enough to have it done. But also its gross, what a turn off!!!!!

    August 22, 2012 at 14:20 | Report abuse | Reply
  45. Mary Tyler Moehl

    Your junk shouldn't resemble an ant-eater. Just sayin'....

    August 22, 2012 at 14:22 | Report abuse | Reply
  46. Andrew D.

    Using the same reasoning as the article... Billions of dollars are spent on women with breast cancer. If we proactively removed the breasts of all baby girls at birth we'd save that money.

    August 22, 2012 at 15:38 | Report abuse | Reply
    • mo

      men get breast cancer too.

      August 22, 2012 at 16:27 | Report abuse |
    • curiousgeorge

      and you are probably a "legitimate" rape supporter....

      August 22, 2012 at 16:28 | Report abuse |
    • NickZadick

      @curious George...are you completely retarded?? Andrew exagerated for effect...but mutilating people to prevent disease is ludicrous!!

      August 22, 2012 at 16:32 | Report abuse |
  47. cut

    Please parents, let your sons decide for themselves when they come of age. Somebody decided for me to have it done and I've been livid about it for the last 35 years.

    August 22, 2012 at 16:02 | Report abuse | Reply
    • curiousgeorge

      you just like skins!

      August 22, 2012 at 16:32 | Report abuse |
  48. Lulu

    I feel the best time to do most procedures such as the removal of the foreskin or as someone else mentioned, earrings would be when a child is an infant. For the most part, the pain and suffering is not remembered opposed to doing it as an adult.. it's a lot more painful and the soreness/aftermath last for a longgg time after. The practice does come from the Bible, but like they said.. there is health benefits to it as well. I think the reason God had it there only to ask you to remove it is a test of faith to see if we will do it. He gave us freewill to make that choice.

    August 22, 2012 at 16:05 | Report abuse | Reply
  49. NickZadick

    Can someone explain how mutilated boys are at decreased risk of aids???? A better way to prevent aids is to not fornicate with HIV infected partners! I am extremely glad my parents chose not to mutilate me!! How about suggesting girls with long labias have them sliced off...see how that flies??

    August 22, 2012 at 16:14 | Report abuse | Reply
  50. curiousgeorge


    August 22, 2012 at 16:29 | Report abuse | Reply
    • NickZadick

      Of course!! I am going to mutilate my children because your sky fairy said so.... what an idîot!!

      August 22, 2012 at 16:36 | Report abuse |
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