Published estimates that have NOT fully taken into account ALL of the problems that afflict the uncircumcised have found that on average the amount per circumcision across all ages versus mean lifetime medical costs in those not circumcised either work out about the same or slightly favor circumcision [121, 194, 330, 510]. That is, circumcision is cost-effective.
In one of these analyses it was stated that if the rate of surgical complications from circumcision was less than 0.6% or if risk of penile problems in uncircumcised males exceeded 17% (cf. the then current baseline of 14%) then circumcision would be preferred on a cost and lifespan basis [330].
A cost-analysis in 2006 stated ‘much of the initial cost of neonatal circumcision is eventually recovered when disease and the medical need (in 8.5%) for post-neonatal circumcision are prevented [510]. This analysis was very conservative, in that it allowed for savings if the amount paid for circumcision was instead put in a bank account and allowed to earn 3% interest for the period before the medical condition arose (e.g., UTI 6 months, balanoposthitis/phimosis 10 y, HIV 40 y, invasive penile cancer 65 y), i.e., the future costs were discounted at an annual rate of 3% [510]. It is of course more likely that the parents would spend the money saved by not having their boy circumcised on something else, rather than invest it in a savings account for the respective periods.
It should moreover, be noted that these analyses did not consider all conditions, for example, prostate cancer, conditions in the female partner such as chlamydia, cervical cancer and genital herpes, inflammatory dermatoses, physical, as well as sexual and other problems in uncircumcised men and their partners [372]. When these conditions are factored in, then the cost of non-circumcision would vastly exceed that of circumcision [372]. That is, there would be a very considerable positive cost-benefit.
For UTI, the treatment cost per outpatient UTI is $150 and per inpatient UTI is $2,200 [510]. Based on a 1-year cumulative incidence of UTI in circumcised and uncircumcised boys is 0.22% vs 2.15%, respectively, the mean inpatient/outpatient facility costs of treatment are $703 vs $1,179 (i.e., taken together, cost is 17 times higher for the uncircumcised) [500].
Cost to treat balanoposthitis and phimosis in 3.5% of uncircumcised males was $150 per case [510].
Cost of treating penile cancer was stated in 1991 as $5000 per year [330]. And even back in 1980, the cost for treatment and lost earnings in a man of 50 with cancer was $103,000 [239]. In a 2006 paper, the lifetime cost of treating penile cancer were estimated as $7,500 [510].
In the case of prostate cancer alone, annual cost (US$3 billion) is over 10 times the cost of the 2 million neonatal circumcisions each year in the USA. The cost of treatment by radiation only averages $13,823 per patient and by radical prostatectomy is $12,250 [218]. The cost, in the USA, for treating the extra cases of penile cancer arising from lack of circumcision has been estimated as $0.8-1.1 billion [376].
For HIV / AIDS treatment cost per case in the USA is $45,198 [510].
If one adds all of the other conditions in males (shown in the diagram preceding ‘Conclusions’ at end) cost is far greater than 10-fold.
Then, if one adds to this the costs in females (cervical cancer, pelvic inflammatory disease, infertility, ectopic pregnancy), the medical cost of lack of circumcision becomes astronomical [372]. On top of this is the emotional cost to those affected and their families.
On top of this is the emotional cost to those affected and their families.
The reader should be made aware that one particular ‘cost-utility analysis’ by an anti-circ activist [587] has been severely criticized [213] and should be disregarded as erroneous.
Everyone has a right to ensure a healthy penis. Many who seek a doctor to circumcise themself or their child may be doing so because of a medical problem. However, most merely want what is best, be it prevention of future problems, or esthetics. These are all valid reasons for requesting circumcision. A medical complaint, even if minor, can be expensive and so circumcision early in life to prevent this happening should help reduce the overall cost by providing a return on a claim to a health insurance provider, if not covered by the health system of the country in which it is done.
