1. Rate of Circumcision in ADULTS

Worldwide approximately 38% of males are circumcised by adulthood as determined by a detailed compilation of data from every country and territory in the world and published in Population Health Metrics [Morris et al. 2016]. This replaces an earlier estimate by the WHO [World Health Organization, 2008a], most of these having been done during childhood, either soon after birth or prior to puberty [Williams & Kapila, 1993].

USA:

Rate is approx. 90% in in the majority white population of males [O'Brien et al., 1995]. About 90% of their circumcisions had been carried out neonatally. A representative, nation-wide survey of all states (National Health and Nutrition Examination Survey (NHANES), 1999-2004, survey) published in 2007 by the Centers for Disease Control (CDC) found that the overall rate in the USA was 79%, with rate varying by race and ethnicity, being 88% in non-Hispanic whites, 73% in blacks, 42% in Mexican-Americans and 50% in others [Xu et al., 2007]. In New York City NYC HANES data show circumcision rate to be 74.5% in US born men and 36.8% in men born elsewhere [McKinney et al., 2008]. Rate was 59.8% in men born 1970-1984, 58.4% for those born 1950-1969, and 49.7% for those born before 1950. It was 71.0% in Whites, 57.9% in Blacks, 54.0% in Asians and 30.0% in Hispanic. Those whose eduction was more than a high school diploma had a rate of 63.7%, a high school diploma 51.9% and less than a high school diploma 37.7%. For men who have sex with men it was 67.7% (being 85.3% for those born in the USA and 35.4% for those born elsewhere) and for heterosexual men was 55.7%.

Prevalence increased, especially in blacks and Hispanics, from the 1940s through the 1970s. Whereas it was 80%, 50% and 34% in Whites, Blacks and Hispanics, respectively, in the 1940s (overall 71%), for those born in the 1970s it had risen to 94%, 91% and 57% in Whites, Blacks and Hispanics, respectively (overall 91%). It then fell in the 1980s to 88%, 81% and 52% for those born in that decade [Xu et al., 2007].

The rate has always been highest in whites at 55% (born before 1890), 44% (1890s), 46% (1900s), 52% (1910s), 61% (1920s), 73% (1930s), 80% (1940s), 90% (1950s), 93% (1960s), 94% (1970s) and 88% (1980s) [Stern & Lachenbruch, 1968; Laumann et al., 1997; Xu et al., 2007].

In San Francisco 56% of 58,598 STI clinic patients examined between 1996 and 2005 were circumcised [Mor et al., 2007]. Rate was Blacks 62%, Whites 60%, Hispanics 42%, Asian or Pacific Islander 48%; gay/bisexual 73%, heterosexual 66% (35% of the cohort were gay/bisexual). Rate rose continuously from 40% for men born in 1920 through to 60% for men born in 1960 and then declined to 43% for men born in 1980 [Mor et al., 2007]. The decline was apparent in all racial group

It should be noted that the San Francisco Bay Area is the heartland of the anti-circumcision movement, being where it started and where its leadership and main activists reside. Clearly this cohort of San Francisco residents differs from the rest of the USA, where circumcision rates are much higher.

In a study of men in Tucson, Arizona, and Tampa, Florida, circumcision rates were 88% in non-Hispanic white men and 66% in Mexican Americans [Nielson et al., 2009]. For American Indians or Alaskan Natives it was 76%. Another study, of men who have sex with men (MSM), in New York City, Philadelphia and Los Angeles, found 74% of Black and 33% of Latino men were circumcised [Millett et al., 2007].

Circumcision rate in US males was, moreover, higher as a function of increase in income [Xu et al., 2007]. (See ‘Socio-sexual aspects’ page for more information.)

The latest data from the Centers for Disease Control and Prevention show that 91% of white American men are circumcised, 76% of Black and 44% of Hispanic [Introcaso et al., 2013] (Prevalence of Circumcision Among Men and Boys) .

UK:

The 2000 British National Survey of Sexual Attitudes and Lifestyle found that 16% of 16-44 year-olds were circumcised, the rate being 20% in those aged 40-44 and 12% in the 16-19 year age group [Dave et al., 2003]. Rates reported in one study were 12.5% for males aged 16-24 years, 15.9% for 25-34 year-olds, and 26.4% for the 35-44 year age group (n = 1,874, 2,111 and 2,049, respectively) [Wellings et al., 1994]. Another found rate was 48% in 305 London males aged 4-93 (av. 42 years of age) [Mallon et al., 2000].

Canada:

Approx. 50% overall, but varies by region and age group (see below in section on rate of infant circumcision).

Australia:

A telephone survey in 2001-02 of 10,173 men aged 16-59 found 59% were circumcised. The rate was 69% for those who were born in Australia [Richters et al., 2006]. However, the rate in those aged 16-20 years was only 32%, leading to public health concerns and a call to increase circumcision [Morris, 2007b]. Most of the men in this survey had been circumcised in infancy. A similar rate of 66% was found amongst 1,427 homosexual men in Sydney in whom circumcision status was confirmed by clinical examination [Templeton et al., 2007].

An earlier report in 1994 found that in adult males in Sydney rate was 62% [Donovan et al., 1994]. And, in a 1995 report, the same group found a 65% circumcision rate [Richters et al., 1995]. In Adelaide rate was 55% [Hart, 1992]. In 2006 there were 1965 claims for circumcision of males aged over 10 by a specialist and 731 by a general practitioner [Medicare, 2007a]. Claims rose 5.4% over the 5 years to 2006. These figures are best for monitoring trends. The actual numbers would have been higher than these, probably very much higher.

New Zealand:

The circumcision rate in 1037 men aged 26 who were born in 19721973 in Dunedin was 40% [Dickson et al., 2005], and in a smaller study in Christchurch was 30% [Fergusson et al., 2006].

SUB-SAHARAN AFRICA:

Overall rate is 62% [Drain et al., 2004]. Circumcision rate varies markedly between tribes that do and do not circumcise. Circumcision is usually done later and rate amongst males over 15 years of age is 8% in Swaziland, 10% in Zimbabwe, 11% in Botswana, 12% in Malawi, 13% in Zambia, 14% in Uganda, 21% in Namibia, 25% in Uganda, 35% in South Africa, and 70% in Tanzania, 83% in Kenya, 85% in Ghana, 90% in Nigeria, 90% in Angola, 90% in the Democratic Republic of Congo, and 92% in Ethiopia (reviewed in[World, 2008b; de Bruyn et al., 2010]).

ASIA:

Generally: 8 out of 27 South and Southeast Asian countries have high rates of circumcision [Gopal, 2009].

Pakistan, Bangladesh, Indonesia, Malaysia:

Very common owing to majority Muslim population in each [Gopal, 2009].

Philippines: 93% [Castellsague et al., 2005]. Of these, 42% have their circumcision before the age of 10, 52% have it done between 10 and 14, and for 5% it is between 15 and 18 [Gopal, 2009].

South Korea: 90-95% (at age 18, the average age for circumcision being 12 years) [Pang & Kim, 2002; Gopal, 2009]. Applies to majority Christian population, not just Muslims.

Thailand: 13% [Castellsague et al., 2005].

China: Xinjiang Uyghur Autonomous Region and Yunnan Province - 19.9% [Sullivan et al., 2009]. Boys aged 11 to 18 in Chongqing  17% [Yang et al., 2009]. Four regions of China, 2.7% amongst boys aged 3-23 [Ben et al., 2008].

Taiwan: 9% (age 13) [Hsieh et al., 2006; Ko et al., 2007].

Cambodia: Low [Gopal, 2009].

Papua New Guinea: Low [Gopal, 2009].

Pacific Islands in general: High (most between 6 and 10 years of age) [Afsari et al., 2002].

Maoris in New Zealand: From high rates in their traditional ancestors, rate has decreased to low levels in recent times, not helped by a Health System in New Zealand that makes it difficult to get a circumcision.

EUROPE:

Spain: 2% [Castellsague et al., 2005].

Slovenia: 4.5% overall, being 7% for Catholic, 92% Muslim, 0% Orthodox, Evangelical, other religious, and 7% (no religious affiliation) [Klavs & Hamers, 2007].

Finland: 1-2% (according to the Finish Ministry of Health, but 7% of Finish males need a circumcision for medical problems [Schoen, 2007e]).

Denmark: 1.6% (age 15) [Frisch et al., 1995]

CENTRAL AND SOUTH AMERICA:

Mexico: 10-30%, depending on the population [Lajous & Mueller, 2006]

Brazil & Columbia: Columbia and Sao Paulo, Brazil 7% [Castellsague et al., 2005]; Rio de Janeiro, Brazil 13% [Périssé et al., 2009].