Too many medically unwarranted circumcisions being done in England

Too many English boys, especially those under the age of five, are being needlessly circumcised, according to a study in the British Medical Journal.

Researchers analyzed only medically indicated circumcision rates for the Mersey region and its health districts for 1975 to 1997, and for England between 1984 and 1986, and between 1990 and 1998.

Circumcisions are usually done for phimosis -- a condition in which the foreskin cannot be pulled back over the glans of the penis -- leading to scarring and potential blockage of the urethra. At birth, the foreskin is almost always non-retractable, but in most boys it becomes movable as they get older.

The results of the analysis showed that similar rates of circumcision were being carried out in the Mersey region and England as a whole. Since the mid-1980s, the trend has been for fewer circumcisions among boys up to the age of four, smaller decreases among five-to-nine year-olds, and static rates among 10-to-14 year-olds.

Each year, around 12,200 circumcisions are carried out for medical reasons. If these rates remain the same, nearly four percent of English boys would be circumcised by the time they are 15, say the study's authors. The equivalent proportion in Liverpool would be one-and-a-half percent.

But, say the authors, true phimosis affects just over half of one percent of all boys, is rarely found before the age of five, and peaks at around the age of 11. While the decreases in the rates are encouraging, they say, too many unnecessary procedures are still being done.

The authors also pointed out that the cost of needless surgery takes its toll on the National Health Service. Decreasing the circumcision rate by 50% -- which is perfectly feasible given the evidence -- would save three million pounds, they say.

SOURCE: British Medical Journal, No 7264 Volume 321, September 30, 2000.

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