Rethinking Healthcare

How the anti-circumcision trend will add billions to U.S. healthcare costs

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Intact foreskins could cost the country $4.4 billion in avoidable health care costs over the next decade if circumcision rates drop to European levels.

What price is America willing to put on a foreskin? $4.4 billion, a team of disease experts and health economists at Johns Hopkins report today in the journal Archives of Pediatrics and Adolescent Medicine. That's the extra health care costs they predict will surface if U.S. circumcision rates continue drop over the next decade.

Currently about 55 percent of males born in the U.S. each year are circumcised. That's down from 79 percent in the seventies and eighties. That decline has already cost the U.S. $2 billion, the experts estimate.

Male circumcision rates in Europe are currently around ten percent. If U.S. rates dropped that low in the next ten years, the authors predict:

  • a 12 percent increase in men infected with HIV
  • 29 percent more men infected with human papillomavirus (HPV)
  • a 19 percent increase in men infected with herpes simplex virus
  • a 211 percent jump in the number of infant male urinary tract infections

This decrease in male circumcision would also increase risks for female sex partners. The researchers predict 50 percent more cases of both bacterial vaginosis and trichomoniasis. Infections of the kind of HPV linked to cervical cancer in women would increase by 18 percent.

Johns Hopkins explains the study methods in a press release:

In the study, researchers constructed a novel economic model to predict the cost implications of not circumcising a male newborn. Included in their forecasting was information from multiple studies and databases that closely tracked the number of overall infections for each sexually transmitted disease, as well as the numbers of new people infected. 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.

Circumcision opponents call the practice cruel. This summer, a German court went as far as to outlaw the procedure for young boys. The New York Daily news reports:

In the United States, a vocal movement of "intactivists," or people who oppose male circumcision, is engaged in a fierce debate with doctors over the practice of clipping baby boys' foreskins.

Actor Russell Crowe may be the most famous of them. Earlier this year he declared on Twitter: "Circumcision is barbaric and stupid," before swiftly tweeting sorry to anyone who thought he was "mocking the rituals and traditions of others."

Photo: Brandon Baunach/Flickr

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Audrey Quinn

Contributing Writer

Audrey Quinn is a Brooklyn-based multimedia journalist focused on health, tech and the economy. Her radio stories can be heard on Marketplace, Studio 360, PRI's The World, NPR's Latino USA, Deutsche Welle Radio and The Believer Magazine podcast. In addition to her work with CBS Interactive she produces multimedia science stories for online publications and is a teaching assistant at the Transom Story Workshop. Her investigative work has been awarded by the Fund for Investigative Journalism and The Nation Institute’s Investigative Fund. Follow her on Twitter. Disclosure