Health & Medicine - Posted by David March-Johns Hopkins on Tuesday, August 21, 2012 9:51 - 13 Comments 
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(3 votes, average: 2.00 out of 5) Loading ...Fewer circumcisions could cost billions
Roughly 55 percent of the 2 million boys born each year in the United States are circumcised, a decline from a high of 79 percent in the 1970s and 1980s, says Johns Hopkins University epidemiologist and pathologist Aaron Tobian. (Credit: iStockphoto)
JOHNS HOPKINS (US) — Flagging rates of male circumcision could cost the US $4.4 billion more in health care expenses, researchers warn.
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The text of this article by Futurity is licensed under a Creative Commons Attribution-No Derivatives License.
The researchers base their predictions on rates of male circumcision in the US continuing to drop over the next decade to levels like those already seen in Europe.
The added expense would stem from expected new cases and higher rates of sexually transmitted infections and related cancers among uncircumcised men and their female partners, according to the report in the Archives of Pediatrics & Adolescent Medicine.
A team of Johns Hopkins University disease experts and health economists says its cost analysis appears to be the first to account for increased rates of multiple infectious diseases associated with lower rates of male circumcision, including HIV/AIDS, herpes, and genital warts, and cervical and penile cancers.
Previous research focused mostly on HIV, the single most costly disease where risk of infection is decreased by male circumcision.
Roughly 55 percent of the 2 million boys born each year in the United States are circumcised, a decline from a high of 79 percent in the 1970s and 1980s, says epidemiologist and pathologist Aaron Tobian, leader of the study. Rates in Europe average 10 percent, and, in Denmark, only 1.6 percent of infant males undergo the procedure.
“Our economic evidence is backing up what our medical evidence has already shown to be perfectly clear,” says Tobian, an assistant professor in the Johns Hopkins University School of Medicine.
“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.”
Circumcision removes foreskin at the tip of the penis, hindering the buildup of bacteria and viruses in the penis’ skin folds. The 20-year decline in the number of circumcised US baby boys has already cost the nation upwards of $2 billion, Tobian and his colleagues estimate.
Their analysis shows that, on average, each male circumcision not performed leads eventually to $313 more in illness-related expenses.
According to the analysis, if circumcision among men born in the same year dropped to European rates, there would be an expected 12 percent increase in men infected with HIV, 29 percent more men infected with human papillomavirus, a 19 percent increase in men infected with herpes simplex virus, and a 211 percent jump in the number of infant male urinary tract infections.
Among their female sex partners, there would be 50 percent more cases each of bacterial vaginosis and trichomoniasis. The number of new infections with the high-risk form of human papillomavirus, which is closely linked to cervical cancer in women, would increase by 18 percent.
State’s choices
State funding cuts in Medicaid, the government medical assistance program for the poor, have contributed substantially to the decline in US infant male circumcisions, Tobian says, noting that 18 states have stopped paying for the procedure.
“The financial and health consequences of these decisions are becoming worse over time, especially if more states continue on this ill-fated path,” he says. “State governments need to start recognizing the medical benefits as well as the cost savings from providing insurance coverage for infant male circumcision.”
The researchers built a new economic model to predict the cost implications of not circumcising a male newborn. Included was information from studies and databases that closely tracked the total number of people infected with each sexually transmitted disease and the numbers of new infections.
Costs were conservatively limited to direct costs for drug treatment, physician visits, and hospital care, and did not include indirect costs from work absences and medical travel expenses.
The most recent states to stop Medicaid funding for infant circumcision were Colorado and South Carolina in 2011.
Other states that do not fund circumcision through Medicaid are Arizona, California, Florida, Idaho Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Oregon, Utah, and Washington.
Source: Johns Hopkins University
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13 Comments
mick
L
You know what else prevents STDs like herpes, HIV and HPV? Condoms! In Europe, where circumcision rates are less than 10%, the STD rate is also quite low. In the U.S. we have about a 55% circumcision rate and a very high rate of STDs. Circumsion does not prevent STDs and scaring parents into mutilating the genitals of their baby boys is disgusting.
Gus
I agree, smells like backlash from fundamentalist groups that have been criticized over circumcision as being unnecessary, traumatic, and affecting sexual satisfaction later in life.
Davey
Ah the benefits of amputation. What else can be cut off to save billions while we are defenseless?
Ed
In an article on the Futurity.com web site one would expect better scientific reporting. What are the STD, etc per capita rates in Europe as compared to USA? What data did the people at Johns Hopkins use to compute the extra cost of not circumcising boys? If lack of circumcision caused an increase in the cost of health care for a society, why haven’t the European countries with government-provided and paid-for health care done something about their low circumcision rates?
Forrest McCanless
Modern research has adequately discounted the “circumcision is a health prophylactic” theory.
Gernot Trolf
You wash yourself don’t you? So include the penis and pull back the foreskin and wash there too. Simple isn’t it?
cindy
Let’s spend the $4.4 Billion on education………maybe the ‘S’ in STD stands for stupidly transmitted disease. Outside of rape and broken condoms this one can be prevented……..just saying.
Nathaniel
Who funded this bogus study. Likely the AMA. Give me a break. This is a bunch of crap.
Mihai-Robert Soran-Schwarz
“The Johns Hopkins team’s analysis showed that, on average, each male circumcision passed over and not performed leads to $313 more in illness-related expenses, costs which Tobian says would not have been incurred if these men had undergone the procedure.”
———> Each skipped male circumcision may cause an additional $ 313 in medical bills. Each circumcision costs between 500 to 2000 USD.
It’s much cheaper to skip MC. And it leaves men with a much more pleasing sex experience due to 5000 more nervous endings in the prepuce. Most of the reported infections counted for by the Hopkins researcher is related to frequent switching of sex partners without use of condoms …
Using consequently condoms, taking hygiene seriously and limiting sex to trustworthy partners would leave the medical bills at similar levels, regardless of MC.
Dianne Watson
I cannot believe that money is even a factor in making this barbaric and brutual unnecessary `procedure a continued practice! To quote Emerson…”Sometimes money costs too much!” People need…men and women…need to take responsiblilty for safe sex practices and proper hygeine! It’s a simple as that! End Routine Infant Circumcision!
Hal
Sooo…… taking their own estimate they predict an average of $313 more in healthcare costs for each uncircumcised male. What is the average cost savings for each circumcision NOT performed, and why is this not entered into the equation? Not to mention the extra cost of increased hospital stays to perform the procedure and the increased costs attributable to botched circumcisions or other complications from the procedure, infections for instance. This not only appears to be bad science, it’s fundamentally flawed math.
Dustin
As soon as the foreskin can safely be retracted, boys need to learn to wash and they need to carry that habit into male adulthood. It is just that simple. Once we’re there, then let’s re-calculate the costs of this unnecessary barbaric amputation procedure.
How much to condoms and soap cost?