Trends in Hysterectomy Incidence Rates During 2000-2015 in Denmark: Shifting from Abdominal to Minimally Invasive Surgical Procedures.
epidemiology
hysterectomy
incidence
indication
surgical procedure
Journal
Clinical epidemiology
ISSN: 1179-1349
Titre abrégé: Clin Epidemiol
Pays: New Zealand
ID NLM: 101531700
Informations de publication
Date de publication:
2021
2021
Historique:
received:
14
01
2021
accepted:
17
04
2021
entrez:
9
6
2021
pubmed:
10
6
2021
medline:
10
6
2021
Statut:
epublish
Résumé
Hysterectomy (removal of the uterus) is a common surgical procedure in gynecology. Although minimally invasive surgical procedures have been introduced, hysterectomy is still associated with risk of short- and long-term complications. Given that hysterectomized women are no longer at risk of either hysterectomy or being diagnosed with endometrial or cervical cancer, it is important to describe trends in hysterectomy rates. To describe trends in hysterectomy incidence rates overall and stratified by age, indication, and procedure. Nationwide population-based cohort study using Danish national registries, 2000-2015, was conducted. We calculated the overall hysterectomy-corrected and age-standardized incidence rates of hysterectomy among women ≥20 years old. Incidence rates were stratified by age group, indication, and surgical procedure. We performed trend analyses using Joinpoint regression, thereby estimating the average annual percentage change (AAPC). A total of 98,484 women had a hysterectomy during the study period, corresponding to an overall age-standardized, hysterectomy-corrected hysterectomy incidence rate (SIR) of 351.1 per 100,000 person-years (95% CI 348.9;353.3). SIR of hysterectomy declined over time (AAPC -1.4; 95% CI -1.9;-1.0), which was driven by a decline in rates of benign hysterectomy (AAPC -2.1; 95% CI -2.7;-1.6). Irrespective of indication, rates of abdominal hysterectomy declined substantially during the study period and were surpassed by rates of minimally invasive procedures (ie, laparoscopy and robot-assisted laparoscopy) in 2013. Hysterectomy-corrected incidence rates of benign hysterectomy declined over time. Irrespective of indication, we observed a shift in surgical procedure over time, from abdominal hysterectomy to minimally invasive surgical procedures.
Sections du résumé
BACKGROUND
BACKGROUND
Hysterectomy (removal of the uterus) is a common surgical procedure in gynecology. Although minimally invasive surgical procedures have been introduced, hysterectomy is still associated with risk of short- and long-term complications. Given that hysterectomized women are no longer at risk of either hysterectomy or being diagnosed with endometrial or cervical cancer, it is important to describe trends in hysterectomy rates.
OBJECTIVE
OBJECTIVE
To describe trends in hysterectomy incidence rates overall and stratified by age, indication, and procedure.
METHODS
METHODS
Nationwide population-based cohort study using Danish national registries, 2000-2015, was conducted. We calculated the overall hysterectomy-corrected and age-standardized incidence rates of hysterectomy among women ≥20 years old. Incidence rates were stratified by age group, indication, and surgical procedure. We performed trend analyses using Joinpoint regression, thereby estimating the average annual percentage change (AAPC).
RESULTS
RESULTS
A total of 98,484 women had a hysterectomy during the study period, corresponding to an overall age-standardized, hysterectomy-corrected hysterectomy incidence rate (SIR) of 351.1 per 100,000 person-years (95% CI 348.9;353.3). SIR of hysterectomy declined over time (AAPC -1.4; 95% CI -1.9;-1.0), which was driven by a decline in rates of benign hysterectomy (AAPC -2.1; 95% CI -2.7;-1.6). Irrespective of indication, rates of abdominal hysterectomy declined substantially during the study period and were surpassed by rates of minimally invasive procedures (ie, laparoscopy and robot-assisted laparoscopy) in 2013.
CONCLUSION
CONCLUSIONS
Hysterectomy-corrected incidence rates of benign hysterectomy declined over time. Irrespective of indication, we observed a shift in surgical procedure over time, from abdominal hysterectomy to minimally invasive surgical procedures.
Identifiants
pubmed: 34103999
doi: 10.2147/CLEP.S300394
pii: 300394
pmc: PMC8180274
doi:
Types de publication
Journal Article
Langues
eng
Pagination
407-416Informations de copyright
© 2021 Lycke et al.
Déclaration de conflit d'intérêts
AH has received a speaker’s fee from Astra Zeneca, Denmark, outside the submitted work; reports grants from Danish Cancer Society, during the conduct of the study. The remaining authors declare no financial or personal conflict of interest.
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