Towards evidence based circumcision of English boys: survey of trends in practice

BMJ 2000; 321 doi: (Published 30 September 2000) Cite this as: BMJ 2000;321:792
  1. A M K Rickwood, consultant urologista,
  2. S E Kenny, lecturer in paediatric surgeryb,
  3. S C Donnell, consultant paediatric surgeonc
  1. a Department of Urology, Alder Hey Children's Hospital, Liverpool L12 2AP
  2. b Department of Child Health, Institute of Child Health, University of Liverpool, Alder Hey Children's Hospital
  3. c Department of Paediatric Surgery, Birmingham Children's Hospital, Birmingham B16 8ET
  1. Correspondence to: A M K Rickwood
  • Accepted 25 May 2000


Although the proportion of English boys circumcised for medical reasons fell from 35% in the early 1930s to 6.5% by the mid-1980s, even latterly it was argued that some two thirds underwent the procedure unnecessarily,1 a judgment consistent with practice in Scandinavia, where less than 2% of boys are circumcised.2 Has any further change occurred in English practice, and, if so, is this evidence based? We examined trends in the catchment population of a children's hospital, in its surrounding region, and in England as a whole.

Subjects, methods, and results

The study was confined to medically indicated operative circumcisions. Statistics for circumcisions for the NHS, including diagnostic codings, were obtained for the Mersey region and its health districts for 1975-97 and for England for 1984-6 and 1990-8. Data for 1996-8 may slightly underestimate the number of procedures performed.3 Corresponding population figures were supplied by the Office …

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