Table 4. Projected effect of a decrease in the prevalence of NMC in the United States from 80% to the level in much of Europe, 10%, on conditions against which NMC protects.
*Based on the latest US CDC Health Statistics data of 1,967,458 male births in 2019.
#Based on data for circumcised vs. uncircumcised males [112,128,150,151].
¥The percentage of males who will be affected over their lifetime as a result of the single risk factor of retention of the foreskin. Data for STIs were estimated after taking into account the external factor of heterosexual exposure and the population prevalence of each STI in the U.S., Canada, Australia, the U.K., or other countries. The estimate of the risk reduction conferred by MC was based mostly on U.S. data because more data from the U.S. were available. As an example of how the results were calculated, for prostate cancer, the lifetime risk in the U.S. is 1 in 8 (0.125), so for a 17% risk reduction conferred by early circumcision, according to a major U.S. study [194], the percent affected would be 0.125 x 0.17 x 100 = 2.1%. The more prevalent a condition, the greater the number of males who will be affected over their lifetime.
∂Number of additional cases if NMC prevalence decreased from 80% to 10% was obtained by multiplying the fraction affected (from column 3) by 1,967,458 x (80 – 10)/100 = 1,101,762.
HPV: human papillomavirus; HIV: human immunodeficiency virus; K: thousand; M: million; Meta: meta-analysis; OS: original study; RCT: randomized controlled trial; SR: systematic review.
| Medical conditions, risk reduction, and number of cases prevented | ||||
| Condition | Decrease in risk# | Approx. % affected¥ | Study type [Reference] | Approx. number of cases prevented∂ |
| Urinary tract infections: lifetime | 72% | 27 | Meta [174] | 420,000 |
| Phimosis persistence at age ≥18 yr | 97% | 3 | SR [175] | 47,000 |
| Balanitis | 68% | 10 | Meta [94] | 160,000 |
| Candidiasis (thrush) | 60% | 10 | OS [176] | 160,000 |
| High-risk HPV infection | 60% | 10 | Meta[177] | 160,000 |
| HIV (acquired heterosexually) | 72% | 0.1 | Meta [178] | 1,000 |
| Genital ulcer disease | 50% | 1 | OS [179-181] | 16,000 |
| Syphilis | 50% | 1 | Meta [182],OS [183] | 16,000 |
| Trichomonas vaginalis | 50% | 1 | RCT [184] | 16,000 |
| Mycoplasma genitalium | 40% | 0.5 | RCT [185] | 8,000 |
| Herpes simplex virus type 2 | 30% | 4 | RCTs [186-189] | 6,000 |
| Chancroid | 50% | 1 | Meta [182] | 1,000 |
| Penile cancer (lifetime) | 95% | 0.1 | OS [190-192] | 2,000 |
| Prostate cancer: population-based | 17% | 2.1 | OS [193] | 42,000 |
| Totals | – | 70 | – | 1,100,000 |