text: by Maria Owings, Ph.D.; Sayeedha Uddin, M.D., M.P.H.; and Sonja Williams, M.P.H., Division of Health Care Statistics 
   
   PDF Version (153 KB) 
   
   This report provides estimates of male newborn circumcisions performed during the birth hospitalization. Using data from the National Hospital Discharge Survey (NHDS), annual rates of newborn circumcision are presented for 1979–2010. National and regional rates are shown in both tabular and graphical form, and trends across the 32-year period are discussed. Note that these estimates do not include circumcisions performed outside the hospital setting (e.g., ritual circumcisions) or those performed at any age following discharge from the birth hospitalization. Thus, these rates cannot be used as prevalence estimates for all male circumcisions in the United States. 
   
   National trends 
   
   Across the 32-year period from 1979 through 2010, the national rate of newborn circumcision declined 10% overall, from 64.5% to 58.3% (Table and Figure 1). During this time, the overall percentage of newborns circumcised during their birth hospitalization was highest in 1981 at 64.9%, and lowest in 2007 at 55.4%. 
   
   However, rates fluctuated during this period, generally declining during the 1980s, rising in the 1990s, and declining again in the early years of the 21st century. These changes occurred during a period of changing guidance on routine newborn circumcision. For example, American Academy of Pediatrics’ (AAP) task force reports during the 1970s (1,2) stated there was no medical indication for routine circumcision of the newborn; AAP revised its position in 1989 (3), stating there were potential medical benefits to newborn circumcision; and then in 1999 (4), an AAP policy statement said that, despite potential medical benefits of newborn male circumcision, there was insufficient evidence to recommend routine circumcision of newborns. 
   
   Regional trends 
   
   Newborn circumcision rates for the four U.S. census regions showed distinctly different patterns (Table and Figure 2). For newborns in the Northeast, the overall trend was flat across the 32 years, and no discernible patterns were evident, although annual rates varied between 60.7% (in 2007) and 69.6% (in 1994). In the Midwest, fluctuations in newborn circumcision rates generally mirrored trends in the national rate: declining until the mid-1980s, increasing until 1998, and then declining again through 2010. Rates ranged between 82.9% in 1998 and 68.8% in 2009. In the South, rates of newborn circumcision generally increased from 1979 until 1998, after which they declined. These rates ranged between 53.8% (in 1988) and 66.1% (in 1995). In marked contrast was the trend for the West. Over the 32-year period, the percentage of newborns receiving circumcision at birth decreased 37%, from 63.9% in 1979 to 40.2% in 2010. Most of this decrease occurred in the 1980s, with the rate dropping to 41.0% in 1989. Rates continued to decrease through 2010, with a low of 31.4% in 2003. 
   
   Data sources and methods 
   
   This report is based on data from NHDS, conducted by the Centers for Disease Control and Prevention’s National Center for Health Statistics (NCHS) from 1965 through 2010. Data on newborn circumcision performed during the birth hospitalization have been collected in NHDS since 1979, when the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD–9–CM) (5) was instituted. NHDS is the only source of reliable, national, historical data on male newborn circumcision performed during the birth hospitalization. 
   
   Circumcision rates for male neonates, based on NHDS data for 1999–2008, were reported and compared with those based on other data sources (i.e., the Nationwide Inpatient Sample from the Agency for Healthcare Research and Quality, and the Charge Data Master from SDI Health, Plymouth Meeting, PA) (6). Observed decreases in the incidence of the procedure differed among the data sources, but the maximum absolute difference for any given year was less than 6%. 
   
   NHDS employed a stratified, clustered, multistage sampling design that produces unbiased national and regional estimates of hospital utilization in the United States. Data were collected from a sample of discharges selected from a national probability sample of nonfederal, short-stay hospitals. This analysis focused only on male newborn infants born during the sampled hospitalization. Circumcision was identified by the presence of ICD–9–CM procedure code 64.0 on the discharge record. 
   
   Newborn circumcision rates over the 1979–2010 period were analyzed using JoinPoint (7), a statistical software program that detects discontinuities in trend lines and tests whether apparent changes in the slope of the trend line are statistically significant. Separate joinpoint models were fitted for the national newborn circumcision rate, as well as for each of the four census regions (Northeast, Midwest, South, and West). The best fit was determined by a series of permutation tests that attempt to fit the data to the smallest number of joinpoints. Statements made about differences, including those referring to increasing or decreasing trends, have been tested and found to be statistically significant. Statistical significance was determined based on an alpha level of 0.05. 
   
   Additional NHDS publications on a range of topics are available from the NCHS website. Public-use electronic data sets are downloadable from the Web, and restricted-format data files are accessible only through the NCHS Research Data Center to authorized users. 
   
   References 
   
   Table 
   
   Figures 
   
   Figure 1. Rates of circumcision performed on male newborn infants discharged from short-stay hospitals: United States, 1979–2010 
   
   NOTES: Rates represent circumcisions performed during birth hospitalization. Circumcision is 
   
   identified by International Classification of Diseases, Ninth Revision, Clinical Modification 
   
   (ICD-9-CM) Procedure Code 64.0. 
   
   SOURCE: CDC/NCHS, National Hospital Discharge Survey. 
   
   Figure 2. Rates of circumcision performed on male newborn infants discharged from short-stay hospitals, by region: United States, 1979–2010 
   
   NOTES: Rates represent circumcisions performed during birth hospitalization. Circumcision is 
   
   identified by International Classification of Diseases, Ninth Revision, Clinical Modification 
   
   (ICD-9-CM) Procedure Code 64.0. 
   
   SOURCE: CDC/NCHS, National Hospital Discharge Survey. 
   
   ||||| Male circumcision has been heavily debated in Denmark in recent years. Photo: Colourbox 
   
   A poll showing 74 percent support for banning male circumcision comes as parliament prepares for a new round of political discussion on male circumcision. 
   
   Nearly three fourths of Danes are in favour of banning male circumcision, a new poll revealed. 
   
   In a survey of over 1,000 Danes conducted by YouGov for Metroxpress newspaper, 74 percent of respondents wanted a full or partial ban on the practice while just ten percent supported giving parents the right to circumcise their sons. 
   
   The poll results come as parliament prepares to hold a hearing on the practice of circumcision on Wednesday. Left-wing party the Red-Green Alliance (Enhedslisten) and libertarian party Liberal Alliance are in favour of a ban, while other parties report internal disagreement on the issue. 
   
   The debate about circumcision is a frequent topic in Denmark. Following extensive media coverage in both 2012 and 2013, the Danish Health and Medicines Authority (Sundhedsstyrelsen) carried out a study on the potential health risks and benefits of circumcision. In June 2013, the agency determined that there was neither enough risk to justify outlawing circumcision nor enough documentation of its benefits to generally recommend the practice. 
   
   Despite the health authorities’ findings, Wednesday’s hearing in parliament may be the first step toward an eventual ban. 
   
   “We will handle this topic politically within a few years. As I see it, it goes against the [UN’s] Convention on the Rights of the Child to circumcise children. I’m leaning toward a ban until the person is of legal age,” Venstre MP Hans Christian Schmidt, a former health minister, told Metroxpress. 
   
   According to Sundhedsstyrelsen, somewhere between 1,000 and 2,000 circumcisions are performed in Denmark each, primarily on Jewish and Muslim boys. Male circumcision is almost universal in the Muslim world and highly prevalent in many African countries. It is also a popular practice in the United States where more than half of all boys are circumcised and in Canada, where a 2007 survey put the percentage at 31.9 percent. 
   
   Jair Melchior of the Jewish faith group Mosaisk Troessamfund cautioned politicians to not let opinion polls affect their stance on circumcision. 
   
   “The problem is that there are so many assertions in the debate on circumcising boys. If it was so dangerous, the Jewish community would have been the first to stop it. But it’s not,” Melchior told Metroxpress.
target: – "To be circumcised should be an informed, personal choice," or so thinks the Danish Medical Association, which on Friday issued its recommendation that no boy under age 18 in the country be circumcised. Going that route then leaves the door open for the male to make a decision of his own "when he has come of age," says Lise Moller, the head of the association’s ethics board. That's not to say the doctors' group is calling for a ban, which it says it weighed and decided against due to cases where male circumcision is medically necessary and for the potential for clandestine botched procedures, says Moller. Had they wanted a ban, they'd possibly face a steep slope. In a June report to the UN, Denmark agreed with Egypt's stance that it is a parental right to circumcise one's male child, reports the Copenhagen Post. Still, the Local reports that 74% of respondents to a 2014 survey said they'd support a full or partial ban. An estimated 1,000 to 2,000 circumcisions take place in Denmark each year, and the country should have a firmer idea of that number as of Jan. 1, after which all circumcisions must be logged in Denmark's national patient registry, reports the Local. Doctors who fail to do so will be fined, reports the Post. The CDC reports that in 2010, an estimated 58% of male newborns were circumcised in the US. (This mom went into hiding and then to jail in an attempt to avoid circumcising her son.)