Current Medical Evidence Supports Male Circumcision

Morris, Brian J.; Cox, Guy

doi:10.1007/978-1-4471-2858-8_19

Cited by 4 publications

(2 citation statements)

References 264 publications

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“…It may also be one of the oldest, likely predating recorded human history [ 1 ]. While religious and cultural considerations are a major reason behind the practice, a growing volume of research attests to the significant medical and public health benefits of male circumcision (MC) [ 2 – 5 ]. Health, medical, sexual, and cosmetic benefits may explain why MC is a fundamentally inherent part of diverse human cultures globally, especially in hot arid environments [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Estimation of country-specific and global prevalence of male circumcision

Morris

Wamai

Henebeng

et al. 2016

Popul Health Metrics

167

130

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BackgroundMale circumcision (MC) status and genital infection risk are interlinked and MC is now part of HIV prevention programs worldwide. Current MC prevalence is not known for all countries globally. Our aim was to provide estimates for country-specific and global MC prevalence.MethodsMC prevalence data were obtained by searches in PubMed, Demographic and Health Surveys, AIDS Indicator Surveys, and Behavioural Surveillance Surveys. Male age was ≥15 years in most surveys. Where no data were available, the population proportion whose religious faith or culture requires MC was used. The total number of circumcised males in each country and territory was calculated using figures for total males from (i) 2015 US Central Intelligence Agency (CIA) data for sex ratio and total population in all 237 countries and territories globally and (ii) 2015 United Nations (UN) figures for males aged 15–64 years.ResultsThe estimated percentage of circumcised males in each country and territory varies considerably. Based on (i) and (ii) above, global MC prevalence was 38.7 % (95 % confidence interval [CI]: 33.4, 43.9) and 36.7 % (95 % CI: 31.4, 42.0). Approximately half of circumcisions were for religious and cultural reasons. For countries lacking data we assumed 99.9 % of Muslims and Jews were circumcised. If actual prevalence in religious groups was lower, then MC prevalence in those countries would be lower. On the other hand, we assumed a minimum prevalence of 0.1 % related to MC for medical reasons. This may be too low, thereby underestimating MC prevalence in some countries.ConclusionsThe present study provides the most accurate estimate to date of MC prevalence in each country and territory in the world. We estimate that 37–39 % of men globally are circumcised. Considering the health benefits of MC, these data may help guide efforts aimed at the use of voluntary, safe medical MC in disease prevention programs in various countries.Electronic supplementary materialThe online version of this article (doi:10.1186/s12963-016-0073-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Estimation of country-specific and global prevalence of male circumcision

Morris

Wamai

Henebeng

et al. 2016

Popul Health Metrics

167

130

View full text Add to dashboard Cite

show abstract

“…Cumulative prevalence to age 16 was 3.6% in uncircumcised boys in a UK study [22]. In US men, circumcision reduced UTI prevalence by 5.6 fold [23], and over the lifetime cumulative incidence of UTI in the uncircumcised is 1 in 4 [24].…”

Section: Urinary Tract Infection (Uti)mentioning

confidence: 96%

Infant male circumcision: An evidence-based policy statement

Morris¹,

Wodak²,

Mindel³

et al. 2012

OJPM

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Here we review the international evidence for benefits and risks of infant male circumcision (MC) and use this to develop an evidence-based policy statement for a developed nation setting, focusing on Australia. Evidence from good quality studies that include meta-analyses and randomized controlled trials showed that MC provides strong protection against: urinary tract infections and, in infancy, renal parenchymal disease; phimosis; paraphimosis; balanoposthitis; foreskin tearing; some heterosexually transmitted infections including HPV, HSV-2, trichomonas, HIV, and genital ulcer disease; thrush; inferior hygiene; penile cancer and possibly prostate cancer. In women, circumcision of the male partner protects against HPV, HSV-2, cervical cancer, bacterial vaginosis, and possibly Chlamydia. MC has no adverse effect on sexual function, sensitivity, penile sensation or satisfaction and may enhance the male sexual experience. Adverse effects are uncommon (<1%), and virtually all are minor and easily treated. For maximum benefits, safety, convenience and cost savings, MC should be performed in infancy and with local anesthesia. A risk-benefit analysis shows benefits exceed risks by a large margin. Over their lifetime up to half of uncircumcised males will suffer a medical condition as a result of retaining their foreskin. The ethics of infant MC and childhood vaccination are comparable. Our analysis finds MC is beneficial, safe and cost-effective, and should optimally be performed in infancy. In the interests of public health and individual wellbeing, adequate parental education, and steps to facilitate access and affordability should be encouraged in developed countries

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Expertise or ideology? A response to Morris et al. 2016, ‘Circumcision is a primary preventive against HIV infection: Critique of a contrary meta-regression analysis by Van Howe’

Howe

2017

Global Public Health

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Current Medical Evidence Supports Male Circumcision

Cited by 4 publications

References 264 publications

Estimation of country-specific and global prevalence of male circumcision

Estimation of country-specific and global prevalence of male circumcision

Infant male circumcision: An evidence-based policy statement

Expertise or ideology? A response to Morris et al. 2016, ‘Circumcision is a primary preventive against HIV infection: Critique of a contrary meta-regression analysis by Van Howe’

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