Details:

Alternative Title:
JAMA Pediatr
Personal Author:
El Bcheraoui, Charbel ; Zhang, Xinjian ; Cooper, Christopher S. ; Rose, Charles E. ; Kilmarx, Peter H. ; ... More +
El Bcheraoui, Charbel ; Zhang, Xinjian ; Cooper, Christopher S. ; Rose, Charles E. ; Kilmarx, Peter H. ; Chen, Robert T. Less -
Description:
Importance

Over 1.4 million male circumcisions are performed annually in U.S. medical settings. However, population-based estimates of male circumcision associated adverse events are lacking.

Objectives

To estimate the incidence rate of male circumcision associated adverse events, and assess whether adverse event rates differed by age at circumcision.

Design

We selected 41 possible male circumcision adverse events based on literature review and medical billing codes. We estimated a likely risk window for incidence calculation for each male circumcision adverse event based on pathogenesis. We used 2001 – 2010 data from SDIhealth, a large administrative claims dataset, to conduct a retrospective cohort study.

Setting

SDIhealth provided administrative claims data from inpatient and outpatient U.S. medical settings.

Main outcome measures

For each adverse event, we calculated incidence per million male circumcisions. We compared incidence risk ratio and incidence rate difference for: a) circumcised vs. uncircumcised newborn males, and b) males circumcised at ≤1 year, 1–9 years, or ≥10 years of age. An adverse event was considered probably related to male circumcision if the incidence risk ratio significantly exceeded one at p<0.05 or occurred only in circumcised males.

Results

Records were available for 1,400,920 circumcised males, 93.3% as newborns. Of the 41 possible male circumcision adverse events, 16 (39%) were probable. Incidence of total male circumcision adverse event was slightly less than half percent. Rates of potentially serious male circumcision adverse events ranged from 0.76 per million male circumcision (95% CI: 0.10 – 5.43) for stricture of male genital organs to 703.23 per million male circumcision (95% CI: 659.22 – 750.18) for repair of incomplete circumcision. Compared to males circumcised at ≤1 year of age, the incidence was approximately 20- and 10-fold greater for males circumcised between 1 – 9 years and those ≥10 years of age, respectively.

Conclusions and Relevance

male circumcision had a relatively low incidence of adverse events overall, especially if the procedure was performed during the first year of life, but rose 10–20 fold when performed after infancy.


Subjects:
[+]
Age Factors Child Child, Preschool Circumcision, Male Humans Incidence Infant Infant, Newborn Male Postoperative Complications Retrospective Studies Risk Factors Treatment Outcome
Source:
JAMA Pediatr. 168(7):625-634.
Pubmed ID:
24820907
Pubmed Central ID:
PMC4578797
Document Type:
Journal Article
Funding:
RTC1/Intramural CDC HHS/United States
Place as Subject:
United States
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:8ab8155a2819658191cfbd04492f3772b4466a233c16745c68fe738b90382144
Download URL:
https://stacks.cdc.gov/view/cdc/34567/cdc_34567_DS1.pdf
File Type:

Supporting Files

• 	NIHMS722375-supplement-Supplement.docx	docx
  	nihms722375.nxml	txt

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