title: Routine circumcision practice in Western Australia 1981-1999.
abstract: BACKGROUND
  Routine neonatal circumcision has declined in most English-speaking countries. The purpose of the present study was to investigate the trends in incidence of routine circumcision in Western Australia and current patterns of the procedure according to sociodemographic factors.
  
  
  METHODS
  Hospital morbidity data were used to conduct a population-based study of all circumcisions performed in Western -Australian hospitals during 1981-1999. Medicare insurance rebate statistics were used to estimate the numbers of circumcisions performed outside of hospital on boys <6 months of age between 1994 and 1999.
  
  
  RESULTS
  In 1994, 9.8% of boys were circumcised before reaching 6 months of age, falling to 7.9% by 1999. Boys <6 months of age were 3.3 times more likely to undergo a hospital-performed circumcision if they lived in country areas compared with metropolitan Perth. Middle socioeconomic class families were twice as likely to circumcise a son than those in the higher and lower socioeconomic groups. The decreasing circumcision rate in boys <6 months of age was partly offset by an increase in routine circumcisions in boys older than 6 months of age during 1981-1999.
  
  
  CONCLUSIONS
  Circumcision remains a relatively common procedure in Western Australia. Based on total routine circumcision rates in 1999, 10.2% of boys will be circumcised by the time they reach 15 years of age. The routine circumcision rate in boys <6 months is falling in contrast to a rising routine circumcision rate in older boys. Risk factors for a circumcision before 6 months of age include living in country areas and a middle socioeconomic status.
authors.affiliation: Western Australian Safety and Quality of Surgical Care Project, Centre for Health Services Research, School of Population Health, University of Western Australia, Crawley, Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Spilsbury
authors.forename: James B
authors.initials: JB
authors.lastname: Semmens
authors.forename: Z Stan
authors.initials: ZS
authors.lastname: Wisniewski
authors.forename: C D'Arcy J
authors.initials: CD
authors.lastname: Holman
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D003710:Demography; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012424:Rural Population; D014505:Urban Population