Prevalence of circumcision

Male circumcision prevalence (not rate) by country according to the World Health Organization's 2007 review of the global trends and determinants of prevalence, safety, and acceptability of circumcision[1]

The prevalence of circumcision is the percentage of males in a given population who have been circumcised. The rates vary widely by country, from virtually 0% in Honduras, to 7% in Spain, to 20% in the United Kingdom, to 45% in South Africa, to 80% in the United States, to over 90% in many Muslim-majority countries.[2][3][4] In 2007, the World Health Organization (WHO) estimated 33% of adult males worldwide (aged 15+) are circumcised, with about two-thirds of those being Muslims.[2]

Overview

Male circumcision is nearly universal in the Muslim world and in Israel due to the religious beliefs of the majority of Muslims and Jews; however, some non-Muslim groups living within Muslim-majority countries, such as Armenians and Assyrians, do not practise it.[5] It is prevalent in some Muslim-majority countries in southeast Asia such as Indonesia and Malaysia; however, the WHO states that there is "little non-religious circumcision in Asia, with the exceptions of the Republic of Korea and the Philippines".[2] In parts of Africa it is often practised as part of tribal or religious customs. The prevalence of circumcision is also high in the United States, although there has been a slight (~6%) decrease in routine neonatal circumcision in recent years.[6]

In contrast, rates are much lower in most of Europe, parts of southern Africa, most of Asia, Oceania and Latin America, constituting South America, Central America, the Caribbean and Mexico.[7]

Australia, Canada, Ireland, New Zealand and the United Kingdom are examples of countries that have seen a decline in male circumcision in recent decades, while there have been indications of increasing demand in southern Africa, partly for preventive reasons due to the HIV epidemic there.[8]

Africa

Studies indicate that about 62% of African males are circumcised. However, the rate varies widely between different regions, and among ethnic and religious groups, with Muslim North Africans practising it for religious reasons, central Africans as part of tribal rituals or local custom, (with some practising female genital mutilation as well) and some traditionally non-circumcising populations in the South recently adopting the practice due to measures by the World Health Organisation to prevent AIDS.[9] Williams, B.G. et al. commented that: "Most of the currently available data on the prevalence of [male circumcision] are several decades old, while several of the recent studies were carried out as adjuncts to demographic and health surveys and were not designed to determine the prevalence of [male circumcision]."[10]

Prevalence of circumcision in Africa
Country WHO

(2006)[11]

 Williams et al

(2006)[10]

 Morris et al

(2016)[12][13]

 Angola>8066 57.5
 Central African Republic20–8067 63
 Chad>8064 73.5
 Republic of the Congo>8070 70
 Democratic Republic of the Congo>8070 97.2
 Gabon>8093 99.2
 Burundi<202 61.7
 Djibouti>8094 96.5
 Eritrea>8095 97.2
 Ethiopia>8076 92.2
 Kenya>8084 91.2
 Rwanda<2010 13.3
 Somalia>8093 93.5
 Sudan20–8047 39.4
 Tanzania20–8070 72
 Uganda20–8025 26.7
 Botswana<2025 15.1
 Lesotho20–800 52
 Malawi<2017 21.6
 Mozambique20–8056 47.4
 Namibia<2015 25.5
 South Africa20–8035 44.7
 Swaziland<2050 8.2
 Zambia<2012 21.6
 Zimbabwe<2010 9.2
 Benin>8084 92.9
 Burkina Faso>8089 88.3
 Cameroon>8093 94
 Equatorial Guinea>8086 87
 Gambia>8090 94.5
 Ghana>8095 91.6
 Guinea>8083 84.2
 Guinea-Bissau>8091 93.3
 Côte d'Ivoire20–8093 96.7
 Liberia>8070 97.7
 Mali>8095 86
 Mauritania>8078 99.2
 Niger>8092 95.5
 Nigeria>8081 98.9
 Senegal>8089 93.5
 Sierra Leone>8090 96.1
 Togo>8093 95.2

Less than 20%

Botswana, Rwanda, Swaziland, Zimbabwe.[12][13]

Between 20% and 80%

Angola, Burundi, Central African Republic, Chad, Congo (Rep), Lesotho, Malawi, Mozambique, Namibia, South Africa, Sudan, Tanzania, Uganda, Zambia.[12][13]

South Africa

It is estimated that 44.7% of males are circumcised in South Africa.[4] One national study reported that 48.2% of black Africans were circumcised, with 32.1% of those traditionally circumcised and 13.4% circumcised for medical reasons.[14]

More than 80%

Benin, Burkin Faso, Cameroon, Congo (Dem Rep), Cote d’Ivoire, Djibouti, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Liberia, Mali, Mauritania, Niger, Nigeria, Senegal, Sierra Leone, Somalia, Togo.[12][13]

The Americas

Less than 20%

Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, El Salvador, Ecuador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Puerto Rico, The Bahamas, Trinidad and Tobago, Uruguay, Venezuela.[11]

The overall prevalence of circumcision is reported to be 6.9% in Colombia, and 7.4% in Brazil (13% in Rio de Janeiro), with most of those being done due to medical issues later in life.[15]

The prevalence of circumcision in Mexico is estimated to be 10% to 31%.[16]

Between 20% and 80%

Canada,[11] United States.[11]

Canada

Rate of neonatal circumcision by province according to data from the Maternity Experiences Survey (MES) in 2006-2007.[17]

Circumcision in Canada followed the pattern that existed in other English speaking countries, picking up the practice during the 1900s to prevent masturbation and other perceived issues of the time, and then had its rate of circumcision decline due to new policy statements passed and due to coverage for the procedure being dropped, with a pattern of declining incidence of circumcision occurring from 1970 to 1979 after a new policy statement was released In 1975.[18] The Canadian Paediatric Society offered an estimate of 48 percent for the prevalence of male circumcision in Canada in 1970 prior to this fall in prevalence.[19] However, when conducting new studies to determine is prevalence in 1977-1978 There was a wide variation in the incidence of circumcision between different provinces and territories. For Example, Yukon reported a rate of 74.8 percent in while Newfoundland reported an incidence of 1.9 to 2.4 percent in 1977-78.[20] The rate continued to drop, with the newborn circumcision rate in Ontario In 1994-95 dropping to 29.9%.[21]

A survey of Canadian maternity practices conducted in 2006/2007 and published in 2009 by the national public health agency found a newborn circumcision rate of 31.9%.[17] Rates varied markedly across the country, from close to zero in Newfoundland and Labrador to 44.3% in Alberta. In 2015, the Canadian Paediatric Society used those statistics in determining their national circumcision rate, with that being the one which is currently used.[17][22]

Percentage of mothers reporting having their male baby circumcised, by province and territory, Canada, 2006/2007
Newfoundland and Labrador*
Prince Edward Island39.2
Nova Scotia6.8
New Brunswick18.0
Quebec12.3
Ontario43.7
Manitoba31.6
Saskatchewan35.6
Alberta44.3
British Columbia30.2
Yukon*
Northwest Territories9.7
Nunavut*
Canada31.9
* Numerator too small for rate calculation
Source:  Canadian Maternity Experiences Survey[17]

United States

The Centers For Disease Control and Prevention (CDC) uses two data sources to track circumcision rates. The first is the National Health and Nutrition Examination Survey (NHANES), which records circumcisions performed at any time at any location. The second is the National Hospital Discharge Survey (NHDS), which does not record circumcisions performed outside the hospital setting or those performed at any age following discharge from the birth hospitalization.[23]

Based off NHANES data, the CDC estimated that 80.5% of American males aged 14 to 59 years old from 2005 to 2010 were circumcised. Among racial breakdown, 90.8% of non-Hispanic whites males, 75.7% of non-Hispanic black, and 44% of Mexican Americans males from that same age group and time span were circumcised.[23]

Based off NHDS data, the CDC reported a national decline in circumcision rates of newborns, from 64.5% to 58.3%, during the 32-year period from 1972 to 2010. Trends varied regionally, with the Midwest mirroring the national trend; in the Northeast there was no discernible trend in the 32-year period; the South experienced an increase in circumcision rates from 1979 until 1998 and then a decline until 2010; finally, the West saw a decrease of 37% during the period in question, with the biggest drop happening in the 1980's, continuing with a slower decrease until 2010.[6] The decline is in large part due to the growing Hispanic population.[23] It is increasingly common due do increasing health care costs that health care providers require the mother and baby to leave the hospital within 24 hours after birth without complications. As a result, a large number of circumcisions are performed in out-patient clinics and are not recorded in the NHDS data.

In 2009, the Healthcare Cost and Utilization Project (HCUP) reported its findings regarding newborn circumcisions based on U.S. region and income bracket. Its data came from several states' hospital associations and health departments. The Western Region reported a rate of 24.6%, the North Central Region reported a rate of 76.2%, the Northeast Region reported a rate of 67%, and the Southern Region reported a rate of 55.7%. The combined newborn circumcision rate of all regions was 54.5%, which is similar but slightly lower than the NHDS data from 2010. There was also significant variation between rural and urban areas. Rural areas reported a rate of 66.9%, while urban areas reported a rate of 41.2%. The lowest income bracket reported a rate of 51.5%, while the highest income bracket reported a rate of 60.4%[24]

Rate of neonatal circumcision in the United States by region in 2009. Based on data from the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project.[24]

Medicaid funding for infant circumcision used to be available in every state, but starting with California in 1982, eighteen states (Arizona, California, Colorado, Florida, Idaho, Louisiana, Maine, Minnesota, Mississippi, Missouri, Montana, Nevada, North Carolina, North Dakota, Oregon, South Carolina, Utah, and Washington) had eliminated Medicaid coverage of routine (non-therapeutic) circumcision by July 2011.[25] One study in the Midwest of the U.S. found that this had no effect on the newborn circumcision rate but it did affect the demand for circumcision at a later time.[26] Another study, published in early 2009, found a difference in the neonatal male circumcision rate of 24% between states with and without Medicaid coverage. The study was controlled for other factors such as the percentage of Hispanic patients.[27]

Circumcision was the second-most common procedure performed on patients under one year of age.[28] There are various explanations for why the infant circumcision rate in the United States is different from comparable countries. Many parents’ decisions about circumcision are preconceived, which may contribute to the high rate of elective circumcision.[29] Brown & Brown (1987) reported the most important factor is whether the father is circumcised.[30]

Asia

Less than 20%

Bhutan, Burma, China,[31] Cambodia, India, Japan, Laos, Mongolia, Nepal, North Korea, Papua New Guinea, Sri Lanka, Taiwan, Thailand, Vietnam.[11]

The overall prevalence of circumcision in Cambodia is reported to be 3.5%.[15]

The overall prevalence of circumcision in China is reported to be 14%.[4]

Between 20% and 60%

The overall prevalence of circumcision in Hong Kong is reported to be 28%.[4]

Between 60% and 80%

Indonesia, Kazakhstan, Malaysia, Pakistan and South Korea.[32]

South Korea

Circumcision is largely a modern-day phenomenon in South Korea. While the rate in the twentieth century has been nearing 80%, virtually no circumcision was performed just a century ago, as it was against Korea's long and strong tradition of preserving the body as a gift from parents.[32] A 2001 study of 20-year-old South Korean men found that 78% were circumcised.[33] At the time, the authors commented that "South Korea has possibly the largest absolute number of teenage or adult circumcisions anywhere in the world. Because circumcision started through contact with the American military during the Korean War, South Korea has an unusual history of circumcision." According to a 2002 study, 86.3% of South Korean males aged 14–29 were circumcised.[34] In 2012, it's the case of 75.8% of the same age group. Only after 1999 has some information against circumcision become available (at the time of the 2012 study, only 3% of Korean internet sites, using the most popular Korean search engine Naver, are against indiscriminate circumcision and 97% are for).[32] The authors of the study speculate "that the very existence of information about the history of Korean circumcision, its contrary nature relative to a longstanding tradition, its introduction by the US military, etc., has been extremely influential on the decision-making process regarding circumcision."[32]

More than 80%

Afghanistan, Azerbaijan, Bahrain, Brunei, Iran, Iraq, Israel,[35] Jordan, Kuwait, Kyrgyzstan, Lebanon, Oman, Palestine, the Philippines,[15] Qatar, Saudi Arabia, Syria, Tajikistan, Turkey, Turkmenistan, Uzbekistan, United Arab Emirates, Yemen.[11]

The overall prevalence of circumcision (tuli) in the Philippines is reported to be 92.5%. Most circumcisions in the Philippines are performed between the ages of 11 to 13.[36][37]

Europe

Less than 20%

Armenia, Austria, Belarus, Belgium, Bulgaria, Croatia, Czech Republic, Cyprus, Denmark, Estonia, Finland, France, Georgia, Germany,[38] Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Russia, Slovakia, Spain, Serbia, Sweden, Switzerland, Ukraine,[11] and the United Kingdom.[39]

A national survey on sexual attitudes in 2000 found that 15.8% of men or boys in the United Kingdom (ages 16–44) were circumcised by their parents' choosing. 11.7% of 16- to 19-year-olds, and 19.6% of 40- to 44-year-olds said they had been circumcised. Apart from black Caribbeans, men born overseas were more likely to be circumcised.[39] Rickwood et al. reported that the proportion of English boys circumcised for medical reasons had fallen from 35% in the early 1930s to 6.5% by the mid-1980s. An estimated 3.8% of male children in the UK in 2000 were being circumcised by the age of 15.[40] The researchers stated that too many boys, especially under the age of 5, were still being circumcised because of a misdiagnosis of phimosis. They called for a target to reduce the percentage to 2%.

In Finland, the overall prevalence of circumcision is 2%, according to a recent publication by the Finnish Health Ministry.[41]

In Germany, the German Health Interview and Examination Survey for Children and Adolescents found that 10.9% of boys aged 0–17 had been circumcised.[38]

In France, according to a telephone survey (TNS Sofres Institute, 2008), 14% of men are circumcised.[42]

The overall prevalence of circumcision in Spain is reported to be 6.6%.[4]

In 1986, 511 out of approximately 478,000 Danish boys aged 0–14 years were circumcised. This corresponds to a cumulative national circumcision rate of around 1.6% by the age of 15 years.[43]

In Slovenia, a 1999-2001 national probability sample of the general population aged 18–49 years found that overall, 4.5% of Slovenian male citizens reported being circumcised. Prevalence strongly varied across religious groups, with 92.4% of Muslims being circumcised, 1.7% of Roman Catholics, 0% of other religious affiliations (Evangelic, Serbian Orthodox, other), and 7.1% of those with no religious affiliation.[44]

Between 20% and 80%

Albania, Kosovo, Republic of Macedonia, and Bosnia and Herzegovina.[11]

In Albania during the years 2008-09 the percentage of men age 15-49 who reported having been circumcised was 47.7%.[45]

Unknown

Andorra, Croatia and Luxembourg are listed as unknown on the WHO prevalence map. Liechtenstein, Malta, Monaco, San Marino and Vatican City are unclear from the map.[11]

Oceania

Australia

Circumcision reached its peak in Australia in the 1950s with a rate of more than 80%, but has steadily fallen to an estimated 26% in 2012. The rate of circumcision has dropped rapidly over the years. It is estimated that males aged at 35 and under are 80%+ uncircumcised while the remaining is circumcised. The uncircumcised male is very common now as young fathers are starting to have children of their own and leaving them intact. [46]

The Australian Longitudinal Study of Health and Relationships is a computer assisted telephone interview of males aged 16–64 that uses a nationally representative population sample.[47] In 2005 the interview found that the prevalence of circumcision in Australia was roughly 58%. Circumcision status was more common with males over 30 than males under 30, and more common with males who were born in Australia. 66% of males born in Australia were circumcised and less than 1/3 of males under 30 were circumcised.[48] There has been a decline in the rate of infant circumcision in Australia.[2][49] The Royal Australasian College of Physicians (RACP) estimated in 2010 that 10 to 20 percent of newborn boys are being circumcised,[50] but the prevalence of male circumcision is much higher due to the presence of older circumcised males remaining in the population.[51] Medicare Australia records show the number of males younger than six months that underwent circumcision dropped from 19,663 in 2007/08 to 6309 (4%) in 2016/17.[52]

New Zealand

According to the World Health Organisation, fewer than 20% of males are circumcised in New Zealand in 2007.[2] In New Zealand routine circumcision for which there is no medical indication is uncommon and no longer publicly funded within the public hospital system.[53] In a study of men born in 1972–1973 in Dunedin, 40.2% were circumcised.[54] In a study of men born in 1977 in Christchurch, 26.1% were circumcised.[55] A 1991 survey conducted in Waikato found that 7% of male infants were circumcised.[56]

Pacific Islands

Circumcision for cultural reasons is routine in Pacific Island countries.[53]

See also

References

  1. ↑ "Male circumcision: Global trends and determinants of prevalence, safety and acceptability" (PDF). World Health Organization. 2007.
  2. 1 2 3 4 5 "Male circumcision: Global trends and determinants of prevalence, safety and acceptability" (PDF). World Health Organization. 2007. Retrieved 2009-03-04.
  3. ↑ "Neonatal and child male circumcision: a global review" (PDF). World Health Organization. 2010. Retrieved 2015-04-12.
  4. 1 2 3 4 5 Morris BJ, Wamai RG, Henebeng EB, Tobian AA, Klausner JD, Banerjee J, Hankins CA (2016-03-01). "Estimation of country-specific and global prevalence of male circumcision". Population Health Metrics. 14 (1): 4. doi:10.1186/s12963-016-0073-5. PMC 4772313. PMID 26933388.
  5. ↑ Vardanyan, Astrik N (2013). "Reclaiming Circumcision: Armenian Stories". Genital Cutting: Protecting Children from Medical, Cultural, and Religious Infringements. pp. 307–315. doi:10.1007/978-94-007-6407-1_20. ISBN 978-94-007-6406-4.
  6. 1 2 The Centers For Disease Control and Prevention, Division of Health Care Statistics. "Trends in Circumcision for Male Newborns in U.S. Hospitals: 1979-2010" (pdf).
  7. ↑ Drain PK, Halperin DT, Hughes JP, Klausner JD, Bailey RC (November 2006). "Male circumcision, religion, and infectious diseases: an ecologic analysis of 118 developing countries". BMC Infectious Diseases. 6 (1): 172. doi:10.1186/1471-2334-6-172. PMC 1764746. PMID 17137513.
  8. ↑ Wise J (July 2006). "Demand for male circumcision rises in a bid to prevent HIV" (PDF). Bulletin of the World Health Organization. 84 (7): 509–11. PMC 2627386. PMID 16878217. As a result, there are already indications of increasing demand for male circumcision in traditionally non-circumcising societies in Southern Africa.
  9. ↑ "Questions and answers: NIAID-sponsored adult male circumcision trials in Kenya and Uganda". National Institute of Allergy and Infectious Diseases. December 2006. Archived from the original on 9 March 2010.
  10. 1 2 Williams BG, Lloyd-Smith JO, Gouws E, Hankins C, Getz WM, Hargrove J, de Zoysa I, Dye C, Auvert B (July 2006). "The potential impact of male circumcision on HIV in Sub-Saharan Africa". PLoS Medicine. 3 (7): e262. doi:10.1371/journal.pmed.0030262. PMC 1489185. PMID 16822094.
  11. 1 2 3 4 5 6 7 8 9 "Information package on male circumcision and HIV prevention: insert 2" (PDF). World Health Organisation. p. 2.
  12. 1 2 3 4 Morris BJ, Wamai RG, Henebeng EB, Tobian AA, Klausner JD, Banerjee J, Hankins CA (2016-03-01). "Estimation of country-specific and global prevalence of male circumcision". Population Health Metrics. 14 (1): 4. doi:10.1186/s12963-016-0073-5. PMID 26933388.
  13. 1 2 3 4 Morris BJ, Wamai RG, Henebeng EB, Tobian AA, Klausner JD, Banerjee J, Hankins CA (2016-04-04). "Erratum to: Estimation of country-specific and global prevalence of male circumcision". Population Health Metrics. 14 (1): 11. doi:10.1186/s12963-016-0080-6. PMC 4820865. PMID 27051352.
  14. ↑ Peltzer K, Onoya D, Makonko E, Simbayi L (2014). "Prevalence and acceptability of male circumcision in South Africa". African Journal of Traditional, Complementary and Alternative Medicines. 11 (4): 126–30. doi:10.4314/ajtcam.v11i4.19. PMC 4202407. PMID 25392591.
  15. 1 2 3 Castellsagué X, Peeling RW, Franceschi S, de Sanjosé S, Smith JS, Albero G, Díaz M, Herrero R, Muñoz N, Bosch FX (November 2005). "Chlamydia trachomatis infection in female partners of circumcised and uncircumcised adult men". American Journal of Epidemiology. 162 (9): 907–16. doi:10.1093/aje/kwi284. PMID 16177149.
  16. ↑ Van Howe RS, Cold CJ, Lajous M, Lazcano-Ponce E, Mueller N (February 2006). "Human papillomavirus link to circumcision is misleading". Cancer Epidemiology, Biomarkers & Prevention. 15 (2): 405, author reply 405–6. doi:10.1158/1055-9965.EPI-05-0818. PMID 16492939. Circumcision is not usually performed by public sector health care providers in Mexico and we estimate the prevalence to be 10% to 31%, depending on the population.
  17. 1 2 3 4 "Data Tables — The Maternity Experiences Survey (MES) 2006–2007 Canadian Maternity Experiences Survey" (PDF). Public Health Agency of Canada. p. 267.
  18. ↑ http://www.cirp.org/library/statements/
  19. ↑ "Neonatal circumcision revisited. Fetus and Newborn Committee, Canadian Paediatric Society". CMAJ. 154 (6): 769–80. March 1996. PMC 1487803. PMID 8634956. Archived from the original on 23 October 2007.
  20. ↑ Wirth JL (November 1980). "Current circumcision practices: Canada". Pediatrics. 66 (5): 705–8. PMID 7432876.
  21. ↑ Goel, V. (ed.) (May 1996). Patterns of Health Care in Ontario, 2nd edition (PDF). Canadian Medical Association. p. 295. ISBN 978-0-920169-79-7.
  22. ↑ Sorakan ST, Finlay JC, Jefferies AL (2015). "Newborn male circumcision". Paediatr Child Health. 20 (6): 311–5. PMC 4578472. PMID 26435672.
  23. 1 2 3 Morris BJ, Bailis SA, Wiswell TE (May 2014). "Circumcision rates in the United States: rising or falling? What effect might the new affirmative pediatric policy statement have?". Mayo Clinic Proceedings. 89 (5): 677–86. doi:10.1016/j.mayocp.2014.01.001. PMID 24702735.
  24. 1 2 Maeda, J. (Thomson Reuters), Chari, R. (RAND), and Elixhauser, A. (AHRQ). Circumcisions in U.S. Community Hospitals, 2009. HCUP Statistical Brief #126. February 2012. Agency for Healthcare Research and Quality, Rockville, MD. Available at http://www.hcup-us.ahrq.gov/reports/statbriefs/sb126.pdf
  25. ↑ Adler PW (December 2011). "Is it lawful to use Medicaid to pay for circumcision?". Journal of Law and Medicine. 19 (2): 335–53. PMID 22320007.
  26. ↑ Quayle SS, Coplen DE, Austin PF (October 2003). "The effect of health care coverage on circumcision rates among newborns". The Journal of Urology. 170 (4 Pt 2): 1533–6, discussion 1536. doi:10.1097/01.ju.0000091215.99513.0f. PMID 14501653.
  27. ↑ Leibowitz AA, Desmond K, Belin T (January 2009). "Determinants and policy implications of male circumcision in the United States". American Journal of Public Health. 99 (1): 138–45. doi:10.2105/AJPH.2008.134403. PMC 2636604. PMID 19008503. The mean mewborn male circumcision rate was 55.9%. When we controlled for other factors, hospitals in states in which Medicaid covers routine male circumcision had circumcision rates that were 24 percentage points higher than did hospitals in states without such coverage (P < .001).
  28. ↑ Pfuntner A., Wier L.M., Stocks C. Most Frequent Procedures Performed in U.S. Hospitals, 2011. HCUP Statistical Brief #165. October 2013. Agency for Healthcare Research and Quality, Rockville, MD. .
  29. ↑ "Report 10 of the Council on Scientific Affairs (I-99):Neonatal Circumcision". 1999 AMA Interim Meeting: Summaries and Recommendations of Council on Scientific Affairs Reports. American Medical Association. December 1999. p. 17. Archived from the original on 5 July 2007. Retrieved 2006-06-13.
  30. ↑ Brown MS, Brown CA (1987). "Circumcision decision: prominence of social concerns". Pediatrics. 60 (2): 215–9. PMID 3615091.
  31. ↑ http://smj.sma.org.sg/2302/2302smj6.pdf
  32. 1 2 3 4 Kim D, Koo SA, Pang MG (December 2012). "Decline in male circumcision in South Korea". BMC Public Health. 12: 1067. doi:10.1186/1471-2458-12-1067. PMC 3526493. PMID 23227923.
  33. ↑ Ku JH, Kim ME, Lee NK, Park YH (February 2003). "Circumcision practice patterns in South Korea: community based survey". Sexually Transmitted Infections. 79 (1): 65–7. doi:10.1136/sti.79.1.65. PMC 1744613. PMID 12576619.
  34. ↑ Pang MG, Kim DS (January 2002). "Extraordinarily high rates of male circumcision in South Korea: history and underlying causes". BJU International. 89 (1): 48–54. doi:10.1046/j.1464-410x.2002.02545.x. PMID 11849160.
  35. ↑ "Israel teaches WHO about circumcision". ynet news. November 2006.
  36. ↑ Darby R (August 2011). "Routine peripubertal circumcision?". CMAJ. 183 (11): 1283–4. doi:10.1503/cmaj.111-2060. PMC 3153524. PMID 21825054.
  37. ↑ Ong, Christine (29 May 2008). "Philippine doctors question medical benefits of circumcision". Channel News Asia. MediaCorp. Retrieved 27 August 2012.
  38. 1 2 Kamtsiuris P, Bergmann E, Rattay P, Schlaud M (2007). "[Use of medical services. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]" [Use of medical services. Results of the German Health Interview and Examination Survey for Children and Adolescents (KiGGS)]. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz (in German). 50 (5–6): 836–50. doi:10.1007/s00103-007-0247-1. PMID 17514470.
  39. 1 2 Dave SS, Fenton KA, Mercer CH, Erens B, Wellings K, Johnson AM (December 2003). "Male circumcision in Britain: findings from a national probability sample survey". Sexually Transmitted Infections. 79 (6): 499–500. doi:10.1136/sti.79.6.499. PMC 1744763. PMID 14663134.
  40. ↑ Rickwood AM, Kenny SE, Donnell SC (September 2000). "Towards evidence based circumcision of English boys: survey of trends in practice". BMJ. 321 (7264): 792–3. doi:10.1136/bmj.321.7264.792. PMC 27490. PMID 11009516.
  41. ↑ Maija K, Taskinen S. "Esinahan kirurgia" (PDF). Retrieved 20 October 2015.
  42. ↑ Telephone survey of the TNS Sofres Institute (commissioned by Manix), 2008 Archived 8 August 2011 at the Wayback Machine..
  43. ↑ Frisch M, Friis S, Kjaer SK, Melbye M (December 1995). "Falling incidence of penis cancer in an uncircumcised population (Denmark 1943-90)". BMJ. 311 (7018): 1471. doi:10.1136/bmj.311.7018.1471. PMC 2543732. PMID 8520335.
  44. ↑ Klavs I, Hamers FF (February 2008). "Male circumcision in Slovenia: results from a national probability sample survey". Sexually Transmitted Infections. 84 (1): 49–50. doi:10.1136/sti.2007.027524. PMID 17881413.
  45. ↑ https://dhsprogram.com/pubs/pdf/FR230/FR230.pdf WHO page 236
  46. ↑ "Incidence and prevalence of circumcision in Australia". Circumcision Information Australia. January 2013. Retrieved 26 June 2018.
  47. ↑ Smith AM, Pitts MK, Shelley JM, Richters J, Ferris J (July 2007). "The Australian longitudinal study of health and relationships". BMC Public Health. 7: 139. doi:10.1186/1471-2458-7-139. PMC 1931435. PMID 17608953.
  48. ↑ Ferris JA, Richters J, Pitts MK, Shelley JM, Simpson JM, Ryall R, Smith AM (April 2010). "Circumcision in Australia: further evidence on its effects on sexual health and wellbeing". Australian and New Zealand Journal of Public Health. 34 (2): 160–4. doi:10.1111/j.1753-6405.2010.00501.x. PMID 23331360.
  49. ↑ Richters J, Smith AM, de Visser RO, Grulich AE, Rissel CE (August 2006). "Circumcision in Australia: prevalence and effects on sexual health". International Journal of STD & AIDS. 17 (8): 547–54. doi:10.1258/095646206778145730. PMID 16925903.
  50. ↑ "Circumcision of Male Infants". Royal Australasian College of Physicians. 2010.
  51. ↑ The incidence of circumcision in Australia was very high until 1971 when it started a steep decline. Consequently, circumcised males tend to be older.
  52. ↑ Rashida Yosufzai (19 February 2018). "Why is the number of male circumcisions declining in Australia?". SBS News. Retrieved 26 June 2018.
  53. 1 2 Afsari M, Beasley SW, Maoate K, Heckert K (March 2002). "Attitudes of Pacific parents to circumcision of boys". Pacific Health Dialog. 9 (1): 29–33. PMID 12737414. Circumcision for cultural reasons is routine in Pacific Island countries.
  54. ↑ Dickson N, van Roode T, Paul C (August 2005). "Herpes simplex virus type 2 status at age 26 is not related to early circumcision in a birth cohort". Sexually Transmitted Diseases. 32 (8): 517–9. doi:10.1097/01.olq.0000161296.58095.ab. PMID 16041257.
  55. ↑ Fergusson DM, Boden JM, Horwood LJ (November 2006). "Circumcision status and risk of sexually transmitted infection in young adult males: an analysis of a longitudinal birth cohort". Pediatrics. 118 (5): 1971–7. doi:10.1542/peds.2006-1175. PMID 17079568.
  56. ↑ Lawrenson RA (May 1991). "Current practice of neonatal circumcision in the Waikato". The New Zealand Medical Journal. 104 (911): 184–5. PMID 1898442.

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