title: Post-infant circumcision amongst children in Hawai'i.
abstract: BACKGROUND
  The purpose of this study is to determine the frequency of circumcision in children older than 12 months of age in US born versus non-US born children in Hawai'i from 1996-2005.
  
  
  METHODS
  Aggregate circumcision data from a children's hospital was obtained from medical records. Birth place was also identified for circumcisions (ICD9 code 64.0) in children 12 months to 18 years of age. Birth place is a surrogate marker of immigration status.
  
  
  RESULTS
  During the 1996-2005 study period, there were 29,408 male births with an average newborn circumcision rate of 89%. The rate of circumcisions has declined from 93% in 1997 to 88% in 2005. There were 552 circumcisions performed on children 12 months to 18 years of age during this study period. Of these, 45 were performed in 1996 and 81 cases were performed in 2005. Birthplace data was missing from 25% of these cases. For those with birthplace data available, 60% of the circumcisions were amongst those born in Hawai'i, 15% were born in the other 49 states and US territories, and 24% were born in a foreign country.
  
  
  CONCLUSIONS
  In a community in which newborn circumcision rates are high, the frequency of circumcision is declining, while the number of circumcisions performed in children aged 1-18 is increasing. The number of circumcisions performed in non-US born children is disproportionately higher than what would be expected suggesting that the post-infant circumcision rates for this age group is higher in immigrants.
authors.affiliation: Kapiolani Medical Center for Women and Children, Honolulu, HI 96826, USA.
authors.forename: Leah Y
authors.initials: LY
authors.lastname: Nakamura
authors.forename: Loren G
authors.initials: LG
authors.lastname: Yamamoto
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D003469:Culture; D006254:Hawaii; D006801:Humans; D007223:Infant; D008297:Male