PMID- 24820907
OWN - NLM
STAT- MEDLINE
DCOM- 20140908
LR  - 20211021
IS  - 2168-6211 (Electronic)
IS  - 2168-6203 (Print)
IS  - 2168-6203 (Linking)
VI  - 168
IP  - 7
DP  - 2014 Jul
TI  - Rates of adverse events associated with male circumcision in U.S. medical 
      settings, 2001 to 2010.
PG  - 625-34
LID - 10.1001/jamapediatrics.2013.5414 [doi]
AB  - IMPORTANCE: Approximately 1.4 million male circumcisions (MCs) are performed 
      annually in US medical settings. However, population-based estimates of 
      MC-associated adverse events (AEs) are lacking. OBJECTIVES: To estimate the 
      incidence rate of MC-associated AEs and to assess whether AE rates differed by 
      age at circumcision. DESIGN: We selected 41 possible MC AEs based on a literature 
      review and on medical billing codes. We estimated a likely risk window for the 
      incidence calculation for each MC AE based on pathogenesis. We used 2001 to 2010 
      data from SDI Health, a large administrative claims data set, to conduct a 
      retrospective cohort study. SETTING AND PARTICIPANTS: SDI Health provided 
      administrative claims data from inpatient and outpatient US medical settings. 
      MAIN OUTCOMES AND MEASURES: For each AE, we calculated the incidence per million 
      MCs. We compared the incidence risk ratio and the incidence rate difference for 
      circumcised vs uncircumcised newborn males and for males circumcised at younger 
      than 1 year, age 1 to 9 years, or 10 years or older. An AE was considered 
      probably related to MC if the incidence risk ratio significantly exceeded 1 at 
      P < .05 or occurred only in circumcised males. RESULTS: Records were available 
      for 1,400,920 circumcised males, 93.3% as newborns. Of 41 possible MC AEs, 16 
      (39.0%) were probable. The incidence of total MC AEs was slightly less than 0.5%. 
      Rates of potentially serious MC AEs ranged from 0.76 (95% CI, 0.10-5.43) per 
      million MCs for stricture of male genital organs to 703.23 (95% CI, 
      659.22-750.18) per million MCs for repair of incomplete circumcision. Compared 
      with boys circumcised at younger than 1 year, the incidences of probable AEs were 
      approximately 20-fold and 10-fold greater for males circumcised at age 1 to 9 
      years and at 10 years or older, respectively. CONCLUSIONS AND RELEVANCE: Male 
      circumcision had a low incidence of AEs overall, especially if the procedure was 
      performed during the first year of life, but rose 10-fold to 20-fold when 
      performed after infancy.
FAU - El Bcheraoui, Charbel
AU  - El Bcheraoui C
AD  - Epidemic Intelligence Service, Division of Applied Sciences, Scientific Education 
      and Professional Development Program, Office of Surveillance, Epidemiology and 
      Laboratory Services, Centers for Disease Control and Prevention, Atlanta, 
      Georgia2Division of.
FAU - Zhang, Xinjian
AU  - Zhang X
AD  - Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, 
      STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, 
      Georgia.
FAU - Cooper, Christopher S
AU  - Cooper CS
AD  - Division of Pediatric Urology, The University of Iowa, Iowa City.
FAU - Rose, Charles E
AU  - Rose CE
AD  - Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, 
      STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, 
      Georgia.
FAU - Kilmarx, Peter H
AU  - Kilmarx PH
AD  - Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, 
      STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, 
      Georgia.
FAU - Chen, Robert T
AU  - Chen RT
AD  - Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, 
      STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, 
      Georgia.
LA  - eng
GR  - CC999999/Intramural CDC HHS/United States
PT  - Journal Article
PL  - United States
TA  - JAMA Pediatr
JT  - JAMA pediatrics
JID - 101589544
SB  - IM
CIN - JAMA Pediatr. 2014 Nov;168(11):1076-7. PMID: 25365387
CIN - JAMA Pediatr. 2014 Nov;168(11):1077. PMID: 25365389
MH  - Age Factors
MH  - Child
MH  - Child, Preschool
MH  - Circumcision, Male/adverse effects/*statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Infant
MH  - Infant, Newborn
MH  - Male
MH  - Postoperative Complications/*epidemiology/etiology
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - United States/epidemiology
PMC - PMC4578797
MID - NIHMS722375
OID - NLM: HHSPA722375
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2014/05/14 06:00
MHDA- 2014/09/10 06:00
PMCR- 2015/09/22
CRDT- 2014/05/14 06:00
PHST- 2014/05/14 06:00 [entrez]
PHST- 2014/05/14 06:00 [pubmed]
PHST- 2014/09/10 06:00 [medline]
PHST- 2015/09/22 00:00 [pmc-release]
AID - 1870232 [pii]
AID - 10.1001/jamapediatrics.2013.5414 [doi]
PST - ppublish
SO  - JAMA Pediatr. 2014 Jul;168(7):625-34. doi: 10.1001/jamapediatrics.2013.5414.