The national rate of newborn circumcision fell by 10% between 1979 and 2010, according to the findings of a national survey.

Maria Owings, PhD, from the Division of Health Care Statistics, Centers for Disease Control and Prevention (CDC), and colleagues present their findings in a report published online August 22 by the CDC's National Center for Health Statistics.

The researchers used data from the National Hospital Discharge Survey to assess national and regional rates of newborn circumcision between 1979 and 2010. The National Hospital Discharge Survey uses a stratified, clustered, multistage sampling design to produce unbiased regional and national estimates of hospital use.

During the study period, the national rate of newborn circumcision declined nationally from 64.5% to 58.3%. The authors note, however, that the data include only those circumcisions performed during the birth hospitalization and thus cannot be considered a prevalence estimate for overall circumcision rates. The data do not include circumcisions performed out of hospital or later in life.

Although circumcisions declined overall during the study period, the change was not steady. The rates declined in the 1980s, rose in the 1990s, and declined again after 2000.

The pattern mirrored changes in the American Academy of Pediatrics (AAP) guidance on newborn circumcision. In the 1970s, AAP guidelines indicated that there was no medical indication for routine circumcision, the academy reversed position in 1989 and suggested newborn circumcision had potential medical benefits. In 1999, the AAP reversed course again, stating that although circumcision may have medical benefits, there is insufficient evidence to recommend routine use of the practice.

Dr. Owings and colleagues also detected significant variation between regions. They found no major trend during the 32-year period in the Northeast, with annual rates ranging between a low of 60.7% in 2007 and a high of 69.9% in 1994. Conversely, the changes in circumcision rates in the Midwest generally mirrored the national trends, as the rate declined until the mid-1980s and then increased until 1998 before falling again until 2010. In addition, circumcision rates were highest in the Midwest during the entire 32-year period, relative to other regions, ranging from a high of 82.9% in 1998 to a low of 68.8%.

In the South, the rate of newborn circumcision increased between 1979 and 1998 and declined thereafter. The annual rates fluctuated between a low of 53.8% in 1988 and a high of 66.1% in 1995.

The greatest changes occurred in the West. There, the rate declined from 63.9% in 1979 to 40.2% in 2010, with the greatest rate of decrease observed in the 1980s.The lowest annual rate during the study period was 31.4% in 2003.

The authors have disclosed no relevant financial relationships.

"Trends in Circumcision Among Male Newborns Born in U.S. Hospitals: 1979–2010." Published online August 22, 2013.