Trends in pediatric circumcision in Belgium and the Brussels University Hospital from



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Trends in Europe


The United Kingdom

Trends in circumcision rate

From the latter half of the 19th century to 1950, the habit of routine male circumcision was accepted in the United Kingdom.7

In 1949, there was a wide difference in the incidence of circumcised infants among the English and Welsh region. The average percentage of circumcised boys was estimated at 20%. Boys from the upper classes were more often circumcised. In a survey among university students, 84% of students coming from the best-known public schools were circumcised as apposed to only 50% of students coming from other grammar or secondary schools. In this survey, data were extracted form observations among 1212 infants, school children and university students around the country. The first serous questioning of the practice of routine circumcision occurred in late 1949, which began to affect the practice by the British.1,7

Fifty years later the average percentage of English boys who underwent circumcision by their 15th birthday was only 3.9%.24 The current guideline of the British Medical Association (BMA) and of the British Association of Paediatric Surgeons states that there is rarely a medical indication for circumcision. The medical evidence about the health impact of male infant circumcision remains questionable according to the BMA.30

An English nationwide study published in 2006 describes the trends in pediatric circumcision in England between 1997 and 2003. Data were extracted from the Hospital Episode Statistics database of admissions to National Health Service hospitals in England. Results show that there is a decrease in the circumcision rate from 2.6 per 1000 boys per year in 1997 to 2.1 in 2003. 3.9% of English boys were circumcised in 1997 by their 15th birthday and 3.1% in 2003. The circumcision rate in boys aged less than 5 years declined by about 30%. In boys aged between 5 and 9 years it declined by nearly 10% and for boys aged between 10 and 14 years the rate increased slightly (1.3 to 1.4%). The indications to circumcise were also investigated in this study (cf. infra “Trends in pediatric circumcision – Trends is Europe - The United Kingdom - Trends in indications”).24

There also was a 66% decrease in the circumcision rate in boys aged 0 to 13 years in Northern Ireland from 1991-1992 to 2001-2002. In 1991-1992 5.7% of boys aged 0 to 13 years underwent circumcision. In the year 2001-2002 this number fell to 1.9%. These data were consistent with trends noted across the other parts of the United Kingdom.56


Trends in indications

An English study described the trends in pediatric circumcision in England between 1997 and 2003. Overall, 90% of the circumcisions were performed for phimosis, 8% for recurrent balanitis and 2% for other reasons. Boys who underwent circumcision for religious or cultural reasons were not included in the study. The decline in the circumcision rate was due to a drop in the frequency of circumcision for phimosis. The number of circumcisions performed for phimosis fell by 23% over the 7 years. The number of circumcisions performed for recurrent balanitis was stable over the 7 years. If the 2003 circumcision rate remains unchanged, 3.1% of English boys would undergo circumcision by their 15th birthday. This number is about five times higher than the reported incidence of phimosis.24

A Scottish study investigated the trends in pediatric circumcision from April 1990 to March 2000. Data were extracted from the Information and Statistics Division of the NHS in Scotland. Over this 10-year period 69.8% of the circumcisions were performed for phimosis, 17.5% for non-medical/religious reasons and 12.8% for other indications (including hypospadias). There was a decrease in the overall number of circumcisions. This is due to a reduction in the circumcisions performed for phimosis. If the 1999-2000 circumcision rate remains stable, 1.98% of boys in Scotland will be circumcised for phimosis by their 13th birthday. The number of procedures performed for non-medical indications has remained relatively stable. However, because of the drop in the circumcisions performed for phimosis, an increasing proportion of boys are circumcised for non-medical reasons (13.4% in the first 5 years of the study period compared to 23.5% in the last five years).57




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