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Hypospadias trends in two US surveillance systems
L J Paulozzi1, J D Erickson, R J Jackson
1National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia 30341-3724, USA.
Pediatrics
|November 14, 1997
Summary
Hypospadias rates in the United States approximately doubled in the 1970s and 1980s, with increases in severe cases. This trend, observed across all US regions, warrants further investigation.
Area of Science:
- Pediatric epidemiology
- Congenital anomaly research
Background:
- Hypospadias is a common congenital anomaly with unknown etiology.
- Previous reports indicated unexplained increases in hypospadias rates in European countries during the 1970s and 1980s.
Purpose of the Study:
- To investigate trends in hypospadias prevalence in the United States.
- To determine if similar increases observed in Europe were also present in the US.
Main Methods:
- Utilized data from the Metropolitan Atlanta Congenital Defects Program (MACDP) (1968-1993) and the Birth Defects Monitoring Program (BDMP) (1970-1993).
- Analyzed population-based prevalence rates, categorized by hypospadias severity (MACDP).
- Examined regional trends across the four census regions of the United States (BDMP).
Main Results:
- Both surveillance systems indicated an approximate doubling of hypospadias rates during the 1970s and 1980s.
- MACDP data revealed an increase in severe hypospadias cases and a decrease in the mild-to-severe case ratio.
- BDMP data showed significant increases in hypospadias rates across all four US census regions.
Conclusions:
- The observed increases in hypospadias rates are unlikely due to enhanced surveillance or increased diagnosis of mild cases.
- These findings represent the largest reported increase in hypospadias cases outside of Europe.
- Further research is recommended to investigate the potential rise in hypospadias prevalence.