Prevalence of circumcision
The prevalence of circumcision is the percentage of males in a given population who have been circumcised, with the procedure most commonly being performed as a part of preventive healthcare, a religious obligation, or cultural practice.
Since 2010, both the
Overview
Present
Rates vary widely, from 99.9% in Morocco,[6] and similarly high rates in many Muslim-majority countries, to 91.7% in Israel,[6] 80% in the United States, to 75% in South Korea, to 58% in Australia, to 45% in South Africa, to 20.7% in the United Kingdom, 14% in China,[6] 9% in Japan,[6] and 1% in Honduras.[7][8][9][10][11][12][13][14][15]
In 2016, the global prevalence of circumcision was estimated to be around 38%, with notable increases of circumcision prevalence seen in the United States, the Middle East; and Africa; major medical organizations have promoted a higher rate of circumcision in Africa as a preventive against the spread of HIV/AIDS.[14][16] In 2020, the World Health Organization reiterated that it is an efficacious prophylactic intervention if carried out by medical professionals under safe conditions in areas of high HIV/AIDS prevalence.[17][18]
Between 2008 and 2010, circumcision prevalence and incidence in the United States were estimated to be around 80%. Wolters Kluwer estimated that closer to 80% of males in 2021 were circumcised.[19][9] The continent of Africa, similarly, has widely adopted the practice as a preventive measure against the spread of HIV. While it has overwhelming prevalence in the Muslim world and in Israel due to the religious beliefs of most Muslims and Jews; however, some non-Muslim groups living within Muslim-majority countries, such as Armenians and Assyrians, do not practice it.[20] It is prevalent in some Muslim-majority countries in southeast Asia such as Indonesia and Malaysia; however, the WHO states that there is "little non-religious circumcision in Asia, with the exceptions of the Republic of Korea and the Philippines".[11] In parts of Africa it is often practiced as part of tribal customs from Christians, Muslims and Animists. In contrast, rates are much lower in most of Europe, parts of southern Africa, most of Asia, Oceania and Latin America, constituting South America, Central America, the Caribbean and Mexico.[21] Australia, Canada, Ireland, New Zealand and the United Kingdom are examples of countries that have seen a decline in male circumcision in recent decades, while there have been indications of increasing demand in southern Africa, partly for preventive reasons due to the HIV epidemic there.[22]
Africa
Studies suggest that about 62% of African males are circumcised.
|
Less than 20%
Botswana, Rwanda, Eswatini, Zimbabwe.[13][27]
Between 20% and 80%
Angola, Burundi,
South Africa
It is estimated that 48.7% of males are circumcised in South Africa.[13] One national study reported that 54.2% of black Africans were circumcised, with 32.1% of those traditionally circumcised and 13.4% circumcised for medical reasons.[28]
More than 80%
Benin, Burkina Faso, Cameroon, Congo (Dem Rep),
Americas
Less than 20%
Less than 20% of the population are circumcised in Argentina, Belize, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Dominican Republic, El Salvador, Ecuador, French Guiana, Guatemala, Guyana, Haiti, Honduras, Jamaica, Nicaragua, Panama, Paraguay, Peru, Suriname, Saint Lucia, The Bahamas, Trinidad and Tobago, Uruguay, Venezuela.[26]
The Bahamas
The reported circumcision rate for younger individuals (age 15–18) is 16.7% (2019).[29]
Argentina
The circumcision rate among homosexual men in Buenos Aires is reported to be 13% (2013).[30]
Brazil
The overall prevalence of circumcision is reported to be 6.9%.[31] The reported rate is 13% in Rio de Janeiro, indicating possible differences between urban and rural rates.[32]
Colombia
The overall prevalence of circumcision is reported to be 6.9%.[31]
Between 20% and 80%
Mexico
In 2006 the prevalence of circumcision in Mexico was estimated to be 10% to 31%.[33] A recent (2020) HIV study conducted in Mexico City found a participant circumcision rate of 23% (255/1118).[34]
Puerto Rico
In 2012 a random sample of male visitors to a STI center in San Juan were surveyed on various topics, the reported circumcision rate was 32.4%.[35]
Canada
![](http://upload.wikimedia.org/wikipedia/commons/thumb/2/22/MaternalExperiencesSurveyCanada.svg/220px-MaternalExperiencesSurveyCanada.svg.png)
Circumcision in Canada followed the pattern of other English speaking countries, with the practice being adopted during the 1900s on hygienic grounds, but with the rate of circumcision declining in the latter part of the 20th century, particularly after a new policy position was released in 1975.
A survey of Canadian maternity practices conducted in 2006/2007, and published in 2009 by the national public health agency, found a newborn circumcision rate of 31.9%.
A more recent survey conducted in 2011 on expecting couples in Saskatchewan (average age 30.3) found the circumcision rate of the male participants to be 61%.[43]
Province/Territory | % | Province/Territory | % |
---|---|---|---|
Alberta | 44.3 | New Brunswick | 18.0 |
Ontario | 43.7 | Quebec | 12.3 |
Prince Edward Island | 39.2 | Northwest Territories | 9.7 |
Saskatchewan | 35.6 | Nova Scotia | 6.8 |
Canada | 31.9 | Newfoundland and Labrador | * |
Manitoba | 31.6 | Nunavut | * |
British Columbia | 30.2 | Yukon | * |
* Numerator too small for rate calculation |
Over 80%
United States
As of 2014, an estimated 80.5% of American men aged 14-59 are circumcised.[14][44] In 2010, the CDC estimated the rate of newborn circumcision in the United States to be 58.3%, and that rates have declined during the period studied (1979-2010).[45] Data from the Healthcare Cost and Utilization Project (HCUP) reported a slightly lower newborn rate of 54.5% in 2009.[46]
Medicaid funding for infant circumcision used to be available in every state, but starting with California in 1982, 13 states (Arizona, California, Idaho, Louisiana, Maine, Minnesota, Mississippi, Montana, Nevada, North Dakota, Oregon, Utah, and Washington) had eliminated Medicaid coverage of routine circumcision by 2024, with several states reversing their decisions and reinstating coverage for the procedure.[47][48][49][50][51][52] One study in the Midwest of the U.S. found that this had no effect on the newborn circumcision rate but it did affect the demand for circumcision at a later time.[53] Another study, published in early 2009, found a difference in the neonatal male circumcision rate of 24% between states with and without Medicaid coverage. The study was controlled for other factors such as the percentage of Hispanic patients.[54]
The CDC uses two data sources to track circumcision rates. The first is the National Health and Nutrition Examination Survey (NHANES), which records circumcisions performed at any time at any location. The second is the National Hospital Discharge Survey (NHDS), which does not record circumcisions performed outside the hospital setting or those performed at any age following discharge from the birth hospitalization.[14]
Circumcision was the second-most common procedure performed on patients under one year of age, after routine inoculations and prophylactic vaccinations.[55] There are various explanations for why the infant circumcision rate in the United States is different from comparable countries. Many parents' decisions about circumcision are preconceived, which may contribute to the high rate of elective circumcision.[56] Brown & Brown (1987) reported the most correlated factor is whether the father is circumcised.[57]
Asia
Less than 20%
Armenia, Bhutan, Burma, China, Cambodia, Hong Kong,[58] India, Japan, Laos, Mongolia, Nepal, North Korea, Papua New Guinea, Singapore, Sri Lanka, Taiwan, Thailand, Vietnam.[26]
India
According to the National Family Health Survey (NFHS-4) the overall circumcision rate in India is 16%.[59]
China
The overall prevalence of circumcision in China is reported to be 14%.[13]
Hong Kong
A sample of children aged <12 found a circumcision rate of 3.4% (1982).[58] A survey on men who regularly visit female sex workers from 2012 found a circumcision rate of 28%.[60]
Singapore
The prevalence of circumcision in Singapore is estimated to be 14.9%.[13]
Taiwan
It is estimated that the circumcision rate for men aged 20–40 is between 10 and 15%.[61]
Cambodia
The overall prevalence of circumcision in Cambodia is reported to be 3.5%.[31]
Between 20% and 80%
Indonesia, Kazakhstan, Lebanon, Malaysia, and South Korea.[62]
South Korea
Circumcision is largely a modern-day phenomenon in South Korea. While during the twentieth century, the rate of circumcision increased to around 80%, virtually no circumcision was performed prior to 1945, as it was against Korea's long and strong tradition of preserving the body as a gift from parents.
More than 80%
Afghanistan, Azerbaijan, Bangladesh,[13] Bahrain, Brunei, Iran, Iraq, Israel,[64] Pakistan,[13] Jordan, Kuwait, Kyrgyzstan, Oman, Palestine, the Philippines,[31] Qatar, Saudi Arabia, Syria, Tajikistan, Turkey, Turkmenistan, Uzbekistan, the United Arab Emirates and Yemen.[26]
The overall prevalence of circumcision (tuli) in the Philippines is reported to be 92.5%. Most circumcisions in the Philippines are performed between the ages of 11 and 13.[65][66]
Europe
Less than 20%
Armenia, Austria, Belarus, Bulgaria, Croatia, Czech Republic, Cyprus, Denmark, Estonia, Finland, France, Georgia, Germany,[67] Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Malta, Moldova, The Netherlands, Norway, Poland, Portugal, Romania, Russia, Slovakia, Slovenia, Spain, Serbia, Sweden, Switzerland, Ukraine,[26] and the United Kingdom.[68]
Germany (<15 %)
An exact number for the circumcision rate in Germany is not available. A 2016 study in Population Health Metrics quotes a survey stating 6.7% for men aged 30 to 61.[69] Public health insurances in Germany paid for 32 thousand circumcisions on boys in 2020.[70]
In this context, a peer-reviewed study found that circumcisions of minors increased slightly throughout the study period between 2013 and 2018. The corresponding population-related number rose from 7.5 circumcisions per 1,000 minors in 2013 to 8 in 2018.[71] A peer-reviewed study in 2021 found that circumcisions were more frequent in the first 5 years of life and above 15 years of age, whereas preputium-preserving procedures were preferred in the age groups between 5 and 14 years of age.[72] Its also claims a decrease in the number of circumcisions in recent years, stating that "[t]he hnumber of circumcisions and preputium-preserving operations decreased in absolute and relative numbers" and that "[t]he increasing trend towards neonatal circumcision observed in the United States is absent in Germany". Neonatal in this context refers to circumcisions shortly after birth.
Another peer-reviewed study in 2023 also reports that among than 38,000 German homosexual men without migration background 19.7% were circumcised.[73]
United Kingdom (15.8%)
A national survey on sexual attitudes in 2000 found that 15.8% of men or boys in the United Kingdom (ages 16–44) were circumcised by their parents' choosing, while 11.7% of 16- to 19-year-olds, and 19.6% of 40- to 44-year-olds said they had been circumcised. Apart from black Caribbeans, men born overseas were more likely to be circumcised.[68] Rickwood et al. reported that the proportion of English boys circumcised for medical reasons had fallen from 35% in the early 1930s to 6.5% by the mid-1980s. As of 2000[update] an estimated 3.8% of male children in the UK were being circumcised for medical reasons by the age of 15.[74] The researchers stated that too many boys, especially under the age of 5, were still being circumcised because of a misdiagnosis of phimosis. They called for a target to reduce the percentage to 2%.
The Netherlands (9 - 16%)
Among participants of the HELIUS study, recruited between 2011 and 2015 (age 18–70), the circumcision rate for Dutch men without a migration background was 9%. The rate was > 95% for men of Moroccan, Turkish or Ghanaian background.[75] A small study from 2019 that recruited homosexual men suffering from various STDs found that 16% of the participants were circumcised.[76]
France (14%)
In France, according to a telephone survey (TNS Sofres Institute, 2008), 14% of men are circumcised.[77]
Bulgaria (13.4%)
The circumcision rate in Bulgaria is estimated to be 13.4%.[13]
Russia (11.8%)
The circumcision rate in Russia is estimated to be 11.8%.[13]
Sweden (11.8%)
A study on hypospadias in 2016 recruited a control group (i.e. men without hypospadias) via the Swedish Population Registry; the reported circumcision rate of the controls was 11.8% with a mean age of 33.[78]
Denmark (1.6 - 7%)
In 1986, 511 out of approximately 478,000 Danish boys aged 0–14 years were circumcised. This corresponds to a cumulative national circumcision rate of around 1.6% by the age of 15 years.[79]
A recent survey (2017–2018) called Project SEXUS surveyed 62,675 Danes aged 15–89 years on sexual topics. The survey found the male circumcision rate to be 7%. Of the respondents 5% were circumcised for medical or other reasons, while 2% were circumcised for religious or traditional reasons.[80]
Spain (6.6%)
The overall prevalence of circumcision in Spain is reported to be 6.6%.[13]
Poland (5%)
A 2017 survey of Polish university students (average age - 25) found a circumcision rate of 5%.[81] This figure is an estimate and fully representative only for students of the university where the survey took place. A 2016 study estimated a prevalence rate of 0.11% in total population.[13]
Slovenia (8.5%)
In Slovenia, a 1999–2001 national probability sample of the general population aged 18–49 years found that overall, 4.5% of Slovenian male citizens reported being circumcised. Prevalence strongly varied across religious groups, with 92.4% of Muslims being circumcised, 1.7% of Roman Catholics, 0% of other religious affiliations (Evangelic, Serbian Orthodox, other), and 7.1% of those with no religious affiliation.[82]
The circumcision rate was reported to be 8.5% in 2016.[13]
Finland (2-4%)
In Finland, the overall prevalence of circumcision is 2–4%, according to a recent publication by the Finnish Health Ministry.[83]
Croatia (1.34%)
A 2016 report found that the circumcision rate in Croatia was 1.34%.[13]
Between 20% and 80%
![](http://upload.wikimedia.org/wikipedia/commons/thumb/c/c2/EQC8HhbW4AAZmAP_%283%29.jpg/170px-EQC8HhbW4AAZmAP_%283%29.jpg)
Belgium,[84][85] Albania, Kosovo, North Macedonia, and Bosnia and Herzegovina.[26]
Bosnia-Herzegovina (58.7% or 41.6%)
In
Albania (36.8% or 47.7%)
In Albania during the years 2008–09 the percentage of men age 15–49 who reported having been circumcised was 47.7%.[88] In the years 2017–18 the circumcision rate in Albania had declined to 36.8%.[89]
Belgium (~22%)
A study on genital sensitivity from 2013 recruited ~1400 adult men through leaflets randomly distributed at railway stations in Belgium. In this study 22.6% of the participants reported being circumcised.[84] The majority identified as being Caucasian with only a very small minority reporting being Asian, Arabic or African. In another more recent (2023) and similarly designed study on genital sensitivity 21.7% (152 out of 702) of participants reported being circumcised.[85]
According to data from the National Institute for Health and Disability Insurance (NIHDI or RIZIV), the number of circumcisions performed in Belgium amounted to 25,286 in the year of 2011. The vast majority of the procedures were performed on individuals aged < 16 years old. If this rate remains stable it is estimated that over time the circumcision rate for boys aged 16 will reach 31.71%.[90]
Over 80%
Kosovo (91.7%), Azerbaijan (98.5%) and Turkey (98.6%).[13]
Oceania
Australia
Circumcision reached its peak in Australia in the 1950s with a rate of more than 80%, but has steadily fallen to an estimated 26% in 2012. The rate of circumcision has dropped rapidly over the years. It is estimated that roughly 80 percent of males 35 and under are not circumcised.[91]
The Australian Longitudinal Study of Health and Relationships is a computer assisted telephone interview of males aged 16–64 that uses a nationally representative population sample.
By state or territory
A study conducted between 2003 and 2004 found that Queensland had the highest circumcision rate in the country in both years, while Western Australia had the lowest rate in 2003 and Tasmania had the lowest rate in 2004.
Infant circumcision in Australia, 2003–2004[97] | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
State/territory | 2004 | 2003 | ±% | ||||||||
No. | % | No. | % | ||||||||
![]() |
94 | 4.8% | 136 | 6.5% | ![]() | ||||||
![]() |
7,219 | 16.3% | 6,692 | 15.8% | ![]() | ||||||
![]() |
91 | 4.5% | 137 | 7.2% | ![]() | ||||||
![]() |
4,824 | 19.5% | 4,806 | 19.6% | ![]() | ||||||
![]() |
1,293 | 14.4% | 1,326 | 14.7% | ![]() | ||||||
![]() |
115 | 3.9% | 227 | 7.5% | ![]() | ||||||
![]() |
1,958 | 6.2% | 1,897 | 6.0% | ![]() | ||||||
![]() |
717 | 6.0% | 698 | 5.8% | ![]() | ||||||
![]() |
16,311 | 12.7% | 16,218 | 12.6% | ![]() |
New Zealand
According to the World Health Organization, fewer than 20% of males are circumcised in New Zealand in 2007.[11] In New Zealand routine circumcision for which there is no medical indication is uncommon and no longer publicly funded within the public hospital system.[98] In a study of men born in 1972–1973 in Dunedin, 40.2% were circumcised.[99] In a study of men born in 1977 in Christchurch, 26.1% were circumcised.[100] A 1991 survey conducted in Waikato found that 7% of male infants were circumcised.[101]
Pacific Islands
Circumcision for cultural reasons is routine in
See also
References and notes
Notes
References
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