Contrary to recent, ignorant, media reports, the incidence of infant circumcision in Australia is not increasing, but, on the contrary, is static nationally and actually declining in most states and territories. This is the conclusion of an analysis of circumcision figures for the period 2000-2010, published in the August issue of the Australian and New Zealand Journal of Public Health. The article compared the Medicare rebate for circumcision of boys under 6 months with male birth statistics, concluding that the incidence of circumcision had stayed pretty steady at 12 per cent across the nation, but with big falls in some states, offset by small rises in others.

The most striking feature of the figures is wide variation among the states – from a low of 1.5 per cent in Tasmania to a high of 17.3 per cent in New South Wales for 2010. In between are the Australian Capital Territory and Western Australia on 6 per cent and 6.8 per cent respectively, and South Australia and Queensland on 15.1 and 14 per cent. Another feature of the figures are the sharp falls in Tasmania, from 9.3 per cent in 2000 to 1.5 per cent in 2010; in the Northern Territory from 7.6 to 2.7 per cent; and in Queensland from 20.3 per cent to 14 per cent. There have been small rises over the same period in Victoria (5.3% to 8%) and New South Wales (14.3% to 17%), though these may well be a product of changes in hospital policy rather than evidence of increased demand for the operation.

The article suggests that the rises in NSW and Victoria may be related to the decision by state governments (NSW in 2006, Vic and SA in 2007) to cease providing non-therapeutic (medically unnecessary) circumcision as a service in their public hospitals. This may have resulted in a shift in the provider of the service from hospitals (where no Medicare rebate is payable or recorded) to GPs and specialist clinics, where the procedure shows up in the Medicare statistics. The rise may thus be more apparent than real. The article wonders why Medicare is providing a rebate for circumcision, considering that the latest statement by the Royal Australasian College of Physicians does not recommend it or regard it as necessary, and the Medicare guidelines state that rebates are not available for “medical services which are not clinically necessary”. The article concludes that there is no evidence for recent assertions that “circumcision is back in favour”, and points out that, on the contrary, it is continuing its slow decline from the high-point of the mid-1950s, and is close to its lowest level for nearly a century.

Source: Robert Darby, Infant circumcision in Australia: A preliminary estimate, 2000-10, Australian and New Zealand Journal of Public Health 35 (4), August 2011.