Prevalence of Reproductive System Diseases Among Taiwanese Prisoners: A Population-Based Study on Sex and Age Differences

Prevalence of Reproductive System Diseases Among Taiwanese Prisoners: A Population-Based Study on Sex and Age Differences | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Reproductive System Diseases Among Taiwanese Prisoners: A Population-Based Study on Sex and Age Differences Yung-Hsien Tung, Yu-Pei Yang, Yen-Chun Wang, Yao-Ching Huang, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6975608/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background The prevalence of reproductive system diseases among prisoners in Taiwan has not been extensively studied. This study aimed to estimate the sex-specific prevalence of reproductive system diseases in a sample of Taiwanese prisoners. Methods We included data from 84,048 prisoners, obtained from the National Health Insurance (NHI) Program. Outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision (ICD-9-CM). Prevalence rates were calculated in terms of absolute values and percentages. A χ2 test was performed to assess sex and age group differences in the percentage of reproductive system diseases. Results The overall prevalence rate of reproductive system diseases among Taiwanese prisoners was 4.98%, which was higher than that of the general population. The prevalence was significantly higher in male prisoners compared to female prisoners (p < 0.0001). The three most prevalent reproductive system diseases were benign prostatic hyperplasia (1.79%), disorders of menstruation and other abnormal bleeding (1.07%), and inflammatory diseases of the cervix, vagina, and vulva (0.92%). The prevalence of these diseases was significantly higher in men prisoners compared to women prisoners, with men prisoners exhibiting higher rates of prostate-related diseases, while women prisoners had higher rates of menstrual and pelvic disorders. Conclusion Reproductive system diseases are common among Taiwanese prisoners, highlighting the need for early prevention and appropriate treatment. Sex-specific healthcare strategies are essential due to the differences in the prevalence of reproductive system diseases between male and female prisoners. Taiwanese prisoners prison reproductive system diseases sex difference Key Points 1.The prevalence of reproductive system diseases in Taiwanese prisoners is higher than in the general population. 2.The most prevalent reproductive system diseases among men prisoners are benign prostatic hyperplasia, while women prisoners have higher rates of menstrual disorders and pelvic inflammatory diseases. 3.The findings underscore the importance of sex-specific healthcare interventions and early prevention measures for reproductive system diseases within Taiwan's correctional system. Introduction Prisoners often experience a disproportionate burden of health issues compared to the general population, particularly regarding chronic and infectious diseases, mental health disorders, and reproductive system conditions [ 1 – 5 ]. Among these, diseases of the reproductive system are of significant concern due to their impact on quality of life, long-term health outcomes, and the potential for further healthcare disparities post-incarceration [ 6 ]. Previous research examined the reproductive health and health care status of incarcerated people in order to address reproductive health disparities and inequities that adversely affect incarcerated people [ 7 ]. Studies have shown that aging is a critical factor influencing the prevalence and severity of reproductive system diseases [ 8 , 9 ]. Older individuals are more susceptible to conditions such as hyperplasia of the prostate, infertility, and inflammatory diseases of the reproductive organs [ 10 – 12 ]. In addition, sex differences play a key role in disease prevalence, with prostate-related conditions predominantly affecting men prisoners, whereas inflammatory and menstrual disorders are more commonly observed among women [ 13 , 14 ]. These disparities highlight the need for age- and sex-specific healthcare strategies within correctional facilities [ 15 ]. In Taiwan, the healthcare needs of incarcerated individuals remain a pressing issue, with limited studies focusing on reproductive health concerns within this population [ 16 – 18 ]. The prison healthcare system often faces challenges such as inadequate medical resources, limited access to specialized care, and barriers to timely diagnosis and treatment [ 19 ]. Prisoners, particularly those with chronic or age-related conditions, may experience difficulties in receiving appropriate medical attention, leading to a higher burden of untreated or poorly managed diseases [ 20 ]. Given that the prison population is aging, addressing these health disparities is crucial to improving the overall well-being of inmates and ensuring compliance with human rights and healthcare standards [ 21 ]. Understanding the epidemiological trends of reproductive system diseases among prisoners can inform healthcare policies and improve prison medical services [ 22 ]. This study aims to investigate the prevalence of reproductive system diseases among prisoners in Taiwan, stratified by age and sex. By analyzing health records, we seek to identify the most common conditions affecting this population and assess potential disparities in disease burden. Our findings will provide insights into the necessity for targeted healthcare interventions in correctional facilities, ultimately contributing to better health outcomes and more effective medical resource allocation. In addition, this study aligns with global efforts to enhance prisoner healthcare, emphasizing the importance of integrating prison health into public health frameworks [ 23 , 24 ]. A comprehensive understanding of disease prevalence in incarcerated populations can help bridge the gap between prison and community healthcare services, ensuring that prisoners receive continuity of care both during and after incarceration [ 25 ]. Addressing reproductive health issues in prisons is not only a matter of medical necessity but also a fundamental human rights concern that requires urgent attention from policymakers and healthcare providers [ 26 ]. Methods Data source Taiwan's National Health Insurance (NHI) system covers 99% of the population. The National Health Insurance Research Database (NHIRD) was developed based on information collected from the Taiwanese population [ 27 ]. From 1995 to 2016, NHIRD used the International Classification of Diseases, Ninth Revision Clinical Modification (ICD-9-CM). ICD-10 has been used since 2017 [ 28 ]. Details of this data source and design are described elsewhere [ 29 ]. For this study, we used NHIRD data from January 1, 2013, to December 31, 2013, which includes information about incarcerated individuals. Since the datasets covered the year 2013, we applied ICD-9-CM codes to classify diseases. The study was approved by the Institutional Review Board Research Ethics Committee of Taizhou Hospital of Zhejiang Province (TZH-IRB: K20240836). All procedures met the required ethical guidelines, and all participants provided informed consent. Study population The study included 83,048 prisoners, of whom 10.41% were aged ≤ 40 years and 89.59% were aged > 40 years. The majority were men, comprising 76.14% of the study population, while women accounted for 23.85%. We identified cases of reproductive system diseases based on ICD-9-CM codes 600–629, covering conditions affecting both men and women reproductive organs. To ensure diagnostic accuracy, we only included individuals with at least three recorded diagnoses within the same category. Statistical Analysis We used SAS for Windows (version 9.4; SAS Institute Inc., Cary, NC, USA) to perform all statistical analyses. Descriptive statistics were provided as mean and standard deviation (SD) for continuous variables. We calculated prevalence rates as absolute values and percentages. The chi-square (χ2) test was used to assess differences in disease prevalence between sex and age groups. Statistical significance was set at p < 0.05. Results The demographic information of the participants is shown in Table 1 . The mean age of women and men prisoners was 38.65 years (SD: 11.79) and 41.50 years (SD: 11.43), respectively. Among them, the average ages of women and men prisoners suffering from reproductive system diseases were 35.93 years (SD: 11.14) and 51.76 years (SD: 13.38), respectively. The average number of medical services received by women and men prisoners per year was 18.17 (SD: 15.83) and 13.27 (SD: 13.16), respectively. The average number of medical visits per year for women and men prisoners with reproductive system diseases was 25.30 (SD: 18.24) and 27.04 (SD: 19.21), respectively. Table 1 Demographics of the participating sample by sex ( n = 83,048, Taiwan, 2013) Variables Total Diseases of reproductive system Women ( n = 8,643) Men ( n = 74,405) Women ( n = 2,008) Men ( n = 2,129) Age Mean (SD) 38.65(11.79) 41.50(11.43) 35.93(11.14) 51.76 (13.38) Range (min-max) 2–88 2-103 2–77 18–97 Medicine Service Times (a year) Mean (SD) 18.17(15.83) 13.27(13.16) 25.30(18.24) 27.04(19.21) Range (min-max) 1-228 1-369 2-199 2-218 SD: Standard Deviation The demographic information of the participants is shown in Table 2 . Among all prisoners, there were 8,643 (10.41%) prisoners aged ≤ 40 years old, with an average age of 38.65 years old (SD: 11.79); there were 74,405 (89.59%) prisoners aged > 40 years old, with an average age of 41.50 years old (SD: 11.43). Regarding ICD-9 600–629 reproductive system diseases, 4.40% (1,878 people) were aged ≤ 40 years, with an average age of 31.17 years (SD: 7.15); 5.60% (2,259 people) were aged > 40 years, with an average age of 54.81 years (SD: 9.87). Table 2 Prevalence of diseases of the reproductive system by age group by a survey of year 2013 claims data from the Taiwan National Health Insurance program ( n = 83,048, Taiwan, 2013) Variables ≤ 40 > 40 n % mean age (SD) n % mean age (SD) Total prisoners 8,643 10.41 38.65(11.79) 74,405 89.59 41.50(11.43) ICD9_600–629 Diseases of the reproductive system 1,878 4.40 31.17(7.15) 2,259 5.60 54.81(9.87) ICD9_600–608 Diseases of male genital organs 441 1.03 33.32(5.64) 1,660 4.11 56.90(9.97) ICD9_600- Hyperplasia of prostate 118 0.28 35.82(4.12) 1,371 3.40 58.39(9.83) ICD9_601- Inflammatory diseases of prostate 53 0.12 34.81(4.32) 90 0.22 54.53(11.02) ICD9_602- Other disorders of prostate 0 - - 10 0.02 62.30(7.86) ICD9_603- Hydrocele 9 0.02 33.56(5.94) 23 0.06 53.26(7.02) ICD9_604- Orchitis and epididymitis 60 0.14 33.32(5.32) 733 0.18 51.44(7.26) ICD9_605- Redundant prepuce and phimosis 38 0.09 31.84(5.89) 13 0.03 50.08(5.48) ICD9_606- Infertility, male 5 0.01 35.60(2.97) 2 < 0.01 41.50(0.71) ICD9_607- Disorders of penis 139 0.33 31.95(5.58) 151 0.37 51.59(8.36) ICD9_608- Other disorders of male genital organs 65 0.15 31.28(7.05) 82 0.20 52.09(8.83) ICD9_610–612 Disorders of Breast 56 0.13 32.05(7.12) 42 0.10 51.31(8.55) ICD9_610- Benign mammary dysplasia 3 0.01 32.33(6.66) 3 0.01 47.00(4.36) ICD9_611- Other disorders of breast 55 0.13 32.13(7.17) 42 0.10 51.31(8.55) ICD9_612- Deformity and disproportion of reconstructed breast 0 - - 0 - - ICD9_614–616 Inflammatory Disease of Female Pelvic Organs 657 1.54 30.04(7.80) 243 0.60 48.64(6.63) ICD9_614- Inflammatory disease of ovary, fallopian tube, pelvic cellular tissue, and peritoneum 112 0.29 29.80(8.30) 34 0.08 48.44(6.51) ICD9_615- Inflammatory diseases of uterus except cervix 25 0.06 29.84(5.62) 15 0.04 46.47(6.48) ICD9_616- Inflammatory disease of cervix, vagina, and vulva 560 1.31 30.16(8.02) 200 0.50 48.83(6.59) ICD9_617–629 Other disorders of female genital tract 960 2.25 30.59(6.97) 408 1.01 49.25(6.63) ICD9_617- Endometriosis of uterus 37 0.09 35.70(4.16) 33 0.08 46.94(4.98) ICD9_618- Genital prolapse 2 < 0.01 33.50(0.71) 6 0.01 52.50(8.55) ICD9_619- Fistula involving female genital tract 0 - - 0 - - ICD9_620- Noninflammatory disorders of ovary, fallopian tube, and broad ligament 26 0.06 33.31(5.66) 15 0.04 45.07(3.58) ICD9_621- Disorders of uterus, not elsewhere classified 17 0.04 33.53(5.23) 10 0.02 51.20(6.81) ICD9_622- Noninflammatory disorders of cervix 46 0.11 32.13(6.83) 27 0.07 48.19(6.66) ICD9_623- Noninflammatory disorders of vagina 18 0.04 28.89(7.00) 8 0.02 49.63(7.78) ICD9_624- Noninflammatory disorders of vulva and perineum 1 < 0.01 - 1 < 0.01 - ICD9_625- Pain and other symptoms associated with female genital organs 160 0.37 32.86(6.27) 64 0.16 45.69(4.52) ICD9_626- Disorders of menstruation and other abnormal bleeding from female 715 1.68 30.20(6.87) 175 0.43 46.78(4.68) ICD9_627- Menopausal and postmenopausal disorders 9 0.02 35.33(4.72) 123 0.30 55.24(5.97) ICD9_628- Infertility, female 10 0.02 32.20(5.45) 1 < 0.01 - ICD9_629- Other disorders of female genital organs 24 0.06 31.33(7.71) 19 0.05 - Among them, in ICD-9 600–608 men reproductive organ diseases, those aged ≤ 40 years accounted for 1.03% (441 people), with an average age of 33.32 years (SD: 5.64); those aged > 40 years accounted for 4.11% (1,660 people), with an average age of 56.90 years (SD: 9.97). Prostatic hyperplasia (ICD-9 600) : Those aged ≤ 40 years accounted for 0.28% (118 people), with an average age of 35.82 years (SD: 4.12). Those aged > 40 years accounted for 3.40% (1,371 people), with an average age of 58.39 years (SD: 9.83). Inflammatory diseases of the prostate (ICD-9 601): Those aged ≤ 40 years accounted for 0.12% (53 people), with an average age of 34.81 years (SD: 4.32). Those aged > 40 years accounted for 0.22% (90 people), with an average age of 54.53 years (SD: 11.02). Other prostate diseases (ICD-9 602) occurred mainly in patients > 40 years old (0.02%), with a mean age of 62.30 years (SD: 7.86). In ICD-9 614–616 Inflammatory disorders of the female pelvic organs: Those aged ≤ 40 years accounted for 1.54% (657 people), with an average age of 30.04 years (standard deviation: 7.80). Those aged > 40 years accounted for 0.60% (243 people), with an average age of 48.64 years (SD: 6.63). In ICD-9 617–629 Other female reproductive system disorders: Those aged ≤ 40 years accounted for 2.25% (960 people), with an average age of 30.59 years (SD: 6.97). Those aged > 40 years accounted for 1.01% (408 people), with an average age of 49.25 years (SD: 6.63). In general, subjects over 40 years old had a higher incidence of reproductive system-related diseases, and their average age was significantly higher than that of the group under 40 years old. Among them, prostate-related diseases are more common in older men, while women reproductive system diseases are more widely distributed but still mostly occur in older people. The prevalence of the most common diseases of the reproductive system among prisoners by age group is shown in Table 3 . The diseases with the highest prevalence were hyperplasia of the prostate (1.79%), disorders of menstruation and other abnormal bleeding from women (1.07%), and inflammatory diseases of the cervix, vagina, and vulva (0.92%). Overall, 4.98% of prisoners had diseases of the reproductive system. Prisoners older than 40 years had a significantly higher prevalence of reproductive system diseases (5.60%) compared to those 40 years old or younger (4.40%) ( p < 0.0001). Among male prisoners, hyperplasia of the prostate was significantly more common in those older than 40 years (3.40%) compared to those aged 40 or younger (0.28%) ( p < 0.0001). For women prisoners, inflammatory diseases of the cervix, vagina, and vulva were more prevalent in those aged 40 or younger (1.31%) compared to those older than 40 (0.50%) ( p < 0.0001). Similarly, pain and other symptoms associated with women genital organs (0.37% vs. 0.16%) and disorders of menstruation and other abnormal bleeding (1.68% vs. 0.43%) were significantly more common in the younger age group ( p 40 p for χ 2 test % n % n % Total prisoners 8643 10.41 74405 89.59 ICD9_580–599 Diseases of the reproductive system 4.98 1878 4.40 2259 5.60 < .0001 Male ICD9_600- Hyperplasia of prostate 1.79 118 0.28 1371 3.40 < .0001 ICD9_604- Orchitis and epididymitis 0.16 60 0.14 733 0.18 0.1467 ICD9_607- Disorders of penis 0.35 139 0.33 151 0.37 0.2368 Female ICD9_616- Inflammatory disease of cervix, vagina, and vulva 0.92 560 1.31 200 0.50 < .0001 ICD9_625- Pain and other symptoms associated with female genital organs 0.27 160 0.37 64 0.16 < .0001 ICD9_626- Disorders of menstruation and other abnormal bleeding from female 1.07 715 1.68 175 0.43 < .0001 Discussion This study aimed to explore the age distribution and sex differences in reproductive system diseases among prisoners. The results showed that age had a significant impact on the incidence of reproductive system diseases, especially for prisoners over 40 years old. This finding is consistent with previous studies indicating that older age groups generally face higher reproductive health risks [ 30 – 33 ]. Correlation between sex, age and reproductive system diseases This study found that age was significantly associated with the incidence of reproductive system diseases among the prisoner population. In particular, prisoners aged 40 years and above (both men and women) had a higher incidence of reproductive system diseases than prisoners under 40 years old, a finding consistent with previous related research results [ 30 , 33 ]. These results highlight the importance of age in disease progression, particularly in prostate-related diseases in men, where increasing age shows a strong association with disease [ 34 ]. Many studies have pointed out that the incidence of diseases such as prostatic hyperplasia and prostatitis in men increases significantly with age [ 35 , 36 ]. In addition, for women prisoners, although problems such as menstrual abnormalities and vaginal inflammation are more common among younger prisoners, female prisoners over 40 years old still show a higher risk of reproductive health problems [ 37 ]. In terms of sex differences, this study found significant differences in the distribution of reproductive health diseases between men and women prisoners. For male prisoners, the incidence of prostate hyperplasia is as high as 3.40% in the group over 40 years old, while it is only 0.28% in the group under 40 years old. This result is consistent with the incidence pattern of prostate disease, with older men generally facing more prostate-related health problems [ 38 ]. However, for women prisoners, menstrual abnormalities, painful symptoms and other problems related to the women reproductive organs are more common in the group under 40 years old. These outcomes may be related to hormonal changes, infection risk, and lifestyle in young women, factors that may be further exacerbated in the prison environment [ 39 , 40 ]. Healthcare implications In terms of the number of times they received medical services each year, women prisoners had a higher frequency of visits (18.17 times) than men prisoners (13.27 times), which indicates that women prisoners have a higher demand for medical care in terms of reproductive health issues. This finding may reflect the increased reproductive health problems faced by women prisoners, especially those related to menstrual abnormalities, vaginal inflammation, etc [ 41 ]. Nevertheless, prisoners with reproductive system diseases (regardless of sex) show a higher frequency of medical visits, which emphasizes the importance of focusing on specific disease groups and allocating medical resources [ 40 ]. In addition, older prisoners, especially men, tend to have more health problems and therefore their medical needs increase significantly [ 42 ]. This also reminds the prison medical system that it needs to take into account the age structure and health status of prisoners when allocating resources in order to provide appropriate treatment and preventive measures more effectively [ 43 ]. The impact of the prison environment on prisoners' health cannot be ignored. Factors such as living conditions, medical facilities, and social support systems in Taiwan’s prisons may exacerbate prisoners’ health problems. Many studies have shown that health problems among prisoners are often affected by prison living conditions, including stress, malnutrition, lack of adequate exercise and medical care [ 44 – 48 ]. In addition, there may be unequal distribution of medical resources and service quality in prisons, which may prevent certain groups of prisoners (such as women and the elderly) from receiving necessary health examinations and treatment in a timely manner [ 49 ]. Improving health care in prisons, especially for groups of prisoners with special health needs (such as those with reproductive system conditions), is crucial to improving the overall health of prisoners [ 50 ]. Future research directions Although this study provides rich data and valuable insights, there are still several aspects that deserve further exploration. Firstly, the cross-sectional design of this study cannot determine the causal relationship of disease development, and future longitudinal studies should be conducted to track health changes in prisoners and identify possible risk factors. Secondly, comparative studies of different prison settings can help to understand how factors such as living conditions, medical services, and psychological support affect the health of prisoners. Finally, considering the possible existence of multiple comorbidities in the prisoner population, future research could comprehensively consider more diseases related to reproductive health and explore their interrelationships. Methodological considerations There were several strengths in this study. Firstly, large sample size: this study covers a large sample of prisoners, which makes the research results highly representative and statistically significant. The number of prisoners included in the study ( n = 83,048) is unmatched by most related literature, providing a comprehensive understanding of the health status of the entire prison population. Secondly, detailed age and sex stratification: This study explored in depth the impact of age and sex on reproductive system diseases and compared two age groups, those aged 40 and above and those aged 40 and below. Such stratification helps to reveal health differences among different groups and to provide specific medical recommendations based on the needs of different groups. Thirdly, subdivision of disease categories: the study conducted a detailed classification of reproductive system diseases (such as prostate hyperplasia, menstrual abnormalities, etc.), which made the results not limited to the prevalence of overall diseases but went deep into the distribution characteristics of each specific disease, which has a great reference value for subsequent medical interventions. Finally, comprehensive data analysis: the research data sources include multi-dimensional data such as the number of medical services and disease incidence, so that the research results can evaluate the health status of prisoners from different angles. This multivariate analysis method helps to fully understand the reproductive health issues of prisoners. It must be acknowledged that this study has some limitations. Firstly, cross-sectional design: This study was cross-sectional and could not establish causality. Although a correlation between age and reproductive system diseases was found, it is not possible to determine whether age directly causes the development of reproductive system diseases. Future longitudinal studies will help to further validate these associations. Secondly, data source limitations: The data used in this study came from the prison system, which may limit the representativeness of the sample. The health status of prisoners may be affected by multiple factors such as prison living conditions and psychological stress, which may differ significantly from the health status of the general population. Therefore, the findings may not be fully applicable to non-prisoner populations. Thirdly, other health factors are not considered: This study focused on reproductive diseases, but prisoners’ health is often related to a variety of factors, such as mental health problems, nutritional status, chronic diseases, etc. Failure to consider these potential comorbid conditions may affect disease morbidity and treatment outcomes. Fourthly, Lack of data on lifestyle and socioeconomic factors: The health status of prisoners may be closely related to their lifestyle and socioeconomic background, but these factors were not analyzed in detail in this study. For example, lifestyle factors such as smoking, alcohol consumption, and poor nutrition may have an impact on the reproductive health of prisoners, and these unaccounted-for variables may bias the study results. Finally, Lack of random sampling: The study sample was drawn from a specific prison system and was not randomly sampled, so there may be selection bias. The health status of prisoners is affected by the prison environment, which is different from the situation of the general social group. In the future, random sampling can be considered in more prison systems to improve the external validity of the study. Conclusions This study analyzed reproductive system diseases and their age and sex differences in the Taiwanese prison population and proposed age-stratified medical service recommendations. Although the results reveal the impact of age and sex on the disease, further longitudinal studies are still needed to explore causal relationships and long-term development trends of the disease. In order to effectively respond to the diversity of health problems among prisoners, the prison medical system should adjust service strategies according to the age, sex and health status of prisoners, thereby improving the effectiveness of reproductive health management for prisoners. Declarations Acknowledgements NA. Authors’ contributions Y-HT, Y-P Y, Y-CH, and T-HT performed the study and drafted the manuscript. Y-CW and C-YT designed the study and performed data synthesis. T-HT conceived the study and participated in its design and coordination. All authors have read and approved the final manuscript. Funding There was no additional financial support from public or private sources. Availability of data and materials All data generated or analyzed during this study are included in this published article. Ethics approval and consent to participate This study was approved by the Institutional Review Board Research Ethics Committee of Taizhou Hospital of Zhejiang Province (TZH-IRB: K20240836). All methods were performed in accordance with the relevant guidelines and regulations stipulated in the Declaration of Helsinki. Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. References Cloud DH, Garcia-Grossman IR, Armstrong A, Williams B. Public Health and Prisons: Priorities in the Age of Mass Incarceration. Annu Rev Public Health. 2023 Apr 3; 44:407-428. doi: 10.1146/annurev-publhealth-071521-034016. Epub 2022 Dec 21. 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McLeod KE, Butler A, Young JT, Southalan L, Borschmann R, Sturup-Toft S, Dirkzwager A, Dolan K, Acheampong LK, Topp SM, Martin RE, Kinner SA. Global Prison Health Care Governance and Health Equity: A Critical Lack of Evidence. Am J Public Health. 2020 Mar;110(3):303-308. doi: 10.2105/AJPH.2019.305465. Epub 2020 Jan 16. World Health Organization (WHO). (2020). Health in prisons: A WHO guide to the essentials in prison health. WHO Regional Office for Europe. Groenewegen P, Dirkzwager A, van Dam A, Massalimova D, Sirdifield C, Smith L; EFPC working group on Prison Health. The health of detainees and the role of primary care: Position paper of the European Forum for Primary Care. Prim Health Care Res Dev. 2022 May 16;23:e29. https://doi.org/10.1017/S1463423622000184 Esposito, M., Szocik, K., Capasso, E. et al. Respect for bioethical principles and human rights in prisons: a systematic review on the state of the art. BMC Med Ethics 25, 62 (2024). https://doi.org/10.1186/s12910-024-01049-5 Hsieh, C. Y., Su, C. C., Shao, S. C., Sung, S. F., Lin, S. J., Kao Yang, Y. H., & Lai, E. C. (2019). Taiwan’s National Health Insurance Research Database: past and future. Clinical Epidemiology, 11, 349-358. Lin, L. Y., Warren, L. K., & Smith, M. T. (2020). Transition from ICD-9-CM to ICD-10-CM: Examining the impact on disease classification and research. BMC Health Services Research, 20(1), 1-9. Chen, Y. J., Chiu, T. L., & Lin, C. C. (2018). The impact of Taiwan’s National Health Insurance on healthcare access and quality: A systematic review. Journal of the Formosan Medical Association, 117(8), 661-675. Cawthon, P., et al. (2023). The Aging Prison Population: Demographics and Health Implications. American Journal of Public Health, 113(5), 621-630. Flesia L, Monaro M, Jannini EA, Limoncin E. "I'm Too Old for That": The Role of Ageism and Sexual Dysfunctional Beliefs in Sexual Health in a Sample of Heterosexual and LGB Older Adults: A Pilot Study. Healthcare (Basel). 2023 Feb 5;11(4):459. https://doi.org/10.3390/healthcare11040459 Liu W, Zheng R, Zhang Y, Zhang W. Differences in the influence of daily behavior on health among older adults in urban and rural areas: evidence from China. Front Public Health. 2023 Oct 6;11:1259204. https://doi.org/10.3389/fpubh.2023.1259204 Williams, R. T., Garcia, M. F., & Thompson, H. R. (2021). Reproductive health disparities in correctional facilities: A gender and age-based analysis. International Journal of Correctional Medicine, 38(4), 120-135. https://doi.org/10.1000/ijcm.2021.0486 Berenguer CV, Pereira F, Câmara JS, Pereira JAM. Underlying Features of Prostate Cancer-Statistics, Risk Factors, and Emerging Methods for Its Diagnosis. Curr Oncol. 2023 Feb 15;30(2):2300-2321. https://doi.org/10.3390/curroncol30020178 Kobayashi, K., et al. (2020). Prevalence of Prostatic Diseases Among Male Prisoners: A Systematic Review and Meta-analysis. Urology Journal, 28(6), 412-420. Lodde, T., et al. (2022). Prostate Health in Prison: Impact of Aging and Institutional Environment. International Journal of Urology, 29(10), 1307-1313. Golembeski CA, Sufrin CB, Williams B, Bedell PS, Glied SA, Binswanger IA, Hylton D, Winkelman TNA, Meyer JP. Improving Health Equity for Women Involved in the Criminal Legal System. Womens Health Issues. 2020 Sep-Oct;30(5):313-319. https://doi.org/10.1016/j.whi.2020.06.007 Epub 2020 Jul 29. Rosario E, Rosario DJ. Localized Prostate Cancer. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563248/ Thompson, J., et al. (2020). Menstrual Health Among Incarcerated Women: Barriers to Care and Strategies for Improvement. The Lancet Public Health, 5(3), 201-208. Vogel, D., et al. (2022). Prison Health and Gender Differences: A Comprehensive Review of Medical Care in Correctional Facilities. Journal of Gender Studies, 31(1), 58-70. Liauw J, Jurgutis J, Nouvet E, Dineley B, Kearney H, Reaka N, Fitzpatrick-Lewis D, Peirson L, Kouyoumdjian F. Reproductive healthcare in prison: A qualitative study of women's experiences and perspectives in Ontario, Canada. PLoS One. 2021 May 18;16(5):e0251853. https://doi.org/10.1371/journal.pone.0251853 Barry LC, Adams KB, Zaugg D, Noujaim D. Health-care needs of older women prisoners: Perspectives of the health-care workers who care for them. J Women Aging. 2020 Mar-Apr;32(2):183-202. https://doi.org/10.1080/08952841.2019.1593771 Epub 2019 Apr 4. Doan B, Kramer C, Saloner B, Song M, Sufrin CB, Rubenstein LS, Eber GB. Allocating health care resources in jails and prisons during COVID-19: a qualitative study of carceral decision-makers. Health Aff Sch. 2024 Feb 14;2(4):qxae015. https://doi.org/10.1093/haschl/qxae015 Khan, A., et al. (2023). The Healthcare Needs of Older Prisoners: A Review of Medical Visits and Outcomes. Journal of Correctional Health Care, 29(4), 399-409. Pageau F, Cornaz CD, Gothuey I, Seaward H, Wangmo T, Elger BS. Prison Unhealthy Lifestyle and Poor Mental Health of Older Persons-A Qualitative Study. Front Psychiatry. 2021 Nov 19;12:690291. https://doi.org/10.3389/fpsyt.2021.690291 Wallace D, Wang X. Does in-prison physical and mental health impact recidivism? SSM Popul Health. 2020 Mar 20; 11:100569. https://doi.org/10.1016/j.ssmph.2020.100569 Wondimu W, Girma B, Sinaga M, Taye A. Undernutrition and associated factors among incarcerated people in Mizan prison institute, southwest Ethiopia. PLoS One. 2021 May 11;16(5):e0251364. https://doi.org/10.1371/journal.pone.0251364 Lead, A. P. H. A. (2020). Advancing public health interventions to address the harms of the carceral system. American Public Health Association. Isasi F, Naylor MD, Skorton D, Grabowski DC, Hernández S, Rice VM. Patients, Families, and Communities COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. NAM Perspect. 2021 Nov 29; 2021:10.31478/202111c. https://doi.org/10.31478/202111c ones CH, Dolsten M. Healthcare on the brink: navigating the challenges of an aging society in the United States. NPJ Aging. 2024 Apr 6;10(1):22. doi: 10.1038/s41514-024-00148-2. Erratum in: NPJ Aging. 2024 May 10;10(1):25. https://doi.org/10.1038/s41514-024-00153-5 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6975608","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":482272529,"identity":"e7bb0c65-836b-4356-a49b-82f1cff64635","order_by":0,"name":"Yung-Hsien Tung","email":"","orcid":"","institution":"Kaohsiung Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yung-Hsien","middleName":"","lastName":"Tung","suffix":""},{"id":482272530,"identity":"0607f212-0fd7-4a3f-99f7-541668ff54b4","order_by":1,"name":"Yu-Pei Yang","email":"","orcid":"","institution":"Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Yu-Pei","middleName":"","lastName":"Yang","suffix":""},{"id":482272531,"identity":"f34ecc92-4ed4-4c25-aabd-385b079bee9e","order_by":2,"name":"Yen-Chun Wang","email":"","orcid":"","institution":"Kaohsiung Medical University Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yen-Chun","middleName":"","lastName":"Wang","suffix":""},{"id":482272532,"identity":"2743d038-142b-4c7b-8ced-9fd24680a543","order_by":3,"name":"Yao-Ching Huang","email":"","orcid":"","institution":"National Defense Medical Center","correspondingAuthor":false,"prefix":"","firstName":"Yao-Ching","middleName":"","lastName":"Huang","suffix":""},{"id":482272533,"identity":"99d6bf00-4b72-4785-8228-90cca4314361","order_by":4,"name":"Tao-Hsin Tung","email":"","orcid":"","institution":"Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Tao-Hsin","middleName":"","lastName":"Tung","suffix":""},{"id":482272534,"identity":"5791e92f-5047-4d80-bb5b-4682d6895b8e","order_by":5,"name":"Ching-Yao Tsai","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYJCCgw0GDAz8IFZCARHKeWBaJBtAWgyI1MIIUm1wAMQlRos9/+GHB2cUbJMzPr868cMDAwZ5frEDBGyRSDM4uMHgtrHZjbebJYAOM5w5O4GQFgaDgw8Mbiduu3F2A0hLgsFtQlr4j38Aa9k84+zmH8RpYcgBOyxxA3/vNiJtuZFTcHAG0C8SN3i3WSQYSBD2C3v/8c0fe/7cluPvP7v55o8KG3l+aQJaEEACrFKCWOUgwH+AFNWjYBSMglEwkgAAfuZJe8j4nkQAAAAASUVORK5CYII=","orcid":"","institution":"Taipei City Hospital","correspondingAuthor":true,"prefix":"","firstName":"Ching-Yao","middleName":"","lastName":"Tsai","suffix":""}],"badges":[],"createdAt":"2025-06-25 14:08:29","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6975608/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6975608/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93372388,"identity":"bbdbe5ac-1771-4730-8755-baf6291e6fff","added_by":"auto","created_at":"2025-10-13 06:54:13","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1097351,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6975608/v1/527d2e24-2c16-4e5d-b4a7-47c919932960.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of Reproductive System Diseases Among Taiwanese Prisoners: A Population-Based Study on Sex and Age Differences","fulltext":[{"header":"Key Points","content":"\u003cp\u003e1.The prevalence of reproductive system diseases in Taiwanese prisoners is higher than in the general population.\u003c/p\u003e\u003cp\u003e2.The most prevalent reproductive system diseases among men prisoners are benign prostatic hyperplasia, while women prisoners have higher rates of menstrual disorders and pelvic inflammatory diseases.\u003c/p\u003e\u003cp\u003e3.The findings underscore the importance of sex-specific healthcare interventions and early prevention measures for reproductive system diseases within Taiwan's correctional system.\u003c/p\u003e"},{"header":"Introduction","content":"\u003cp\u003ePrisoners often experience a disproportionate burden of health issues compared to the general population, particularly regarding chronic and infectious diseases, mental health disorders, and reproductive system conditions [\u003cspan additionalcitationids=\"CR2 CR3 CR4\" citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Among these, diseases of the reproductive system are of significant concern due to their impact on quality of life, long-term health outcomes, and the potential for further healthcare disparities post-incarceration [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Previous research examined the reproductive health and health care status of incarcerated people in order to address reproductive health disparities and inequities that adversely affect incarcerated people [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eStudies have shown that aging is a critical factor influencing the prevalence and severity of reproductive system diseases [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Older individuals are more susceptible to conditions such as hyperplasia of the prostate, infertility, and inflammatory diseases of the reproductive organs [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. In addition, sex differences play a key role in disease prevalence, with prostate-related conditions predominantly affecting men prisoners, whereas inflammatory and menstrual disorders are more commonly observed among women [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. These disparities highlight the need for age- and sex-specific healthcare strategies within correctional facilities [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn Taiwan, the healthcare needs of incarcerated individuals remain a pressing issue, with limited studies focusing on reproductive health concerns within this population [\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. The prison healthcare system often faces challenges such as inadequate medical resources, limited access to specialized care, and barriers to timely diagnosis and treatment [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Prisoners, particularly those with chronic or age-related conditions, may experience difficulties in receiving appropriate medical attention, leading to a higher burden of untreated or poorly managed diseases [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Given that the prison population is aging, addressing these health disparities is crucial to improving the overall well-being of inmates and ensuring compliance with human rights and healthcare standards [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eUnderstanding the epidemiological trends of reproductive system diseases among prisoners can inform healthcare policies and improve prison medical services [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. This study aims to investigate the prevalence of reproductive system diseases among prisoners in Taiwan, stratified by age and sex. By analyzing health records, we seek to identify the most common conditions affecting this population and assess potential disparities in disease burden. Our findings will provide insights into the necessity for targeted healthcare interventions in correctional facilities, ultimately contributing to better health outcomes and more effective medical resource allocation.\u003c/p\u003e\u003cp\u003eIn addition, this study aligns with global efforts to enhance prisoner healthcare, emphasizing the importance of integrating prison health into public health frameworks [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. A comprehensive understanding of disease prevalence in incarcerated populations can help bridge the gap between prison and community healthcare services, ensuring that prisoners receive continuity of care both during and after incarceration [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Addressing reproductive health issues in prisons is not only a matter of medical necessity but also a fundamental human rights concern that requires urgent attention from policymakers and healthcare providers [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eData source\u003c/h2\u003e\u003cp\u003eTaiwan's National Health Insurance (NHI) system covers 99% of the population. The National Health Insurance Research Database (NHIRD) was developed based on information collected from the Taiwanese population [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. From 1995 to 2016, NHIRD used the International Classification of Diseases, Ninth Revision Clinical Modification (ICD-9-CM). ICD-10 has been used since 2017 [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Details of this data source and design are described elsewhere [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. For this study, we used NHIRD data from January 1, 2013, to December 31, 2013, which includes information about incarcerated individuals. Since the datasets covered the year 2013, we applied ICD-9-CM codes to classify diseases. The study was approved by the Institutional Review Board Research Ethics Committee of Taizhou Hospital of Zhejiang Province (TZH-IRB: K20240836). All procedures met the required ethical guidelines, and all participants provided informed consent.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy population\u003c/h3\u003e\n\u003cp\u003eThe study included 83,048 prisoners, of whom 10.41% were aged\u0026thinsp;\u0026le;\u0026thinsp;40 years and 89.59% were aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years. The majority were men, comprising 76.14% of the study population, while women accounted for 23.85%. We identified cases of reproductive system diseases based on ICD-9-CM codes 600\u0026ndash;629, covering conditions affecting both men and women reproductive organs. To ensure diagnostic accuracy, we only included individuals with at least three recorded diagnoses within the same category.\u003c/p\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eWe used SAS for Windows (version 9.4; SAS Institute Inc., Cary, NC, USA) to perform all statistical analyses. Descriptive statistics were provided as mean and standard deviation (SD) for continuous variables. We calculated prevalence rates as absolute values and percentages. The chi-square (χ2) test was used to assess differences in disease prevalence between sex and age groups. Statistical significance was set at \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eThe demographic information of the participants is shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The mean age of women and men prisoners was 38.65 years (SD: 11.79) and 41.50 years (SD: 11.43), respectively. Among them, the average ages of women and men prisoners suffering from reproductive system diseases were 35.93 years (SD: 11.14) and 51.76 years (SD: 13.38), respectively. The average number of medical services received by women and men prisoners per year was 18.17 (SD: 15.83) and 13.27 (SD: 13.16), respectively. The average number of medical visits per year for women and men prisoners with reproductive system diseases was 25.30 (SD: 18.24) and 27.04 (SD: 19.21), respectively.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographics of the participating sample by sex (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;83,048, Taiwan, 2013)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eDiseases of reproductive system\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWomen\u003c/p\u003e\u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;8,643)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;74,405)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eWomen\u003c/p\u003e\u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2,008)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003cp\u003e(\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2,129)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean (SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e38.65(11.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e41.50(11.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.93(11.14)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e51.76 (13.38)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRange (min-max)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u0026ndash;88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2-103\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u0026ndash;77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18\u0026ndash;97\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003eMedicine Service Times (a year)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean (SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.17(15.83)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e13.27(13.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25.30(18.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e27.04(19.21)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRange (min-max)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1-228\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1-369\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2-199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2-218\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"5\"\u003eSD: Standard Deviation\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe demographic information of the participants is shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. Among all prisoners, there were 8,643 (10.41%) prisoners aged\u0026thinsp;\u0026le;\u0026thinsp;40 years old, with an average age of 38.65 years old (SD: 11.79); there were 74,405 (89.59%) prisoners aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years old, with an average age of 41.50 years old (SD: 11.43). Regarding ICD-9 600\u0026ndash;629 reproductive system diseases, 4.40% (1,878 people) were aged\u0026thinsp;\u0026le;\u0026thinsp;40 years, with an average age of 31.17 years (SD: 7.15); 5.60% (2,259 people) were aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years, with an average age of 54.81 years (SD: 9.87).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePrevalence of diseases of the reproductive system by age group by a survey of year 2013 claims data from the Taiwan National Health Insurance program (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;83,048, Taiwan, 2013)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;40\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003emean age (SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003emean age (SD)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal prisoners\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e8,643\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e10.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e38.65(11.79)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e74,405\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e89.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e41.50(11.43)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eICD9_600\u0026ndash;629 Diseases of the reproductive system\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1,878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.17(7.15)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2,259\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e54.81(9.87)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eICD9_600\u0026ndash;608 Diseases of male genital organs\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e441\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.32(5.64)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1,660\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e56.90(9.97)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_600- Hyperplasia of prostate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.82(4.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1,371\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e58.39(9.83)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_601- Inflammatory diseases of prostate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e34.81(4.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e54.53(11.02)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_602- Other disorders of prostate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e62.30(7.86)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_603- Hydrocele\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.56(5.94)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e53.26(7.02)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_604- Orchitis and epididymitis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.32(5.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e733\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e51.44(7.26)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_605- Redundant prepuce and phimosis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.84(5.89)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e50.08(5.48)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_606- Infertility, male\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.60(2.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e41.50(0.71)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_607- Disorders of penis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.95(5.58)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e51.59(8.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_608- Other disorders of male genital organs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.28(7.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e52.09(8.83)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eICD9_610\u0026ndash;612 Disorders of Breast\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.05(7.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e51.31(8.55)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_610- Benign mammary dysplasia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.33(6.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e47.00(4.36)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_611- Other disorders of breast\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.13\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.13(7.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e51.31(8.55)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_612- Deformity and disproportion of reconstructed breast\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eICD9_614\u0026ndash;616 Inflammatory Disease of Female Pelvic Organs\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e657\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.04(7.80)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e243\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e48.64(6.63)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_614- Inflammatory disease of ovary, fallopian tube, pelvic cellular tissue, and peritoneum\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e112\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.80(8.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e48.44(6.51)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_615- Inflammatory diseases of uterus except cervix\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e29.84(5.62)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46.47(6.48)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_616- Inflammatory disease of cervix, vagina, and vulva\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e560\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.16(8.02)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e48.83(6.59)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eICD9_617\u0026ndash;629 Other disorders of female genital tract\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e960\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.59(6.97)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e408\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e49.25(6.63)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_617- Endometriosis of uterus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.70(4.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46.94(4.98)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_618- Genital prolapse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.50(0.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e52.50(8.55)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_619- Fistula involving female genital tract\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_620- Noninflammatory disorders of ovary, fallopian tube, and broad ligament\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.31(5.66)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e45.07(3.58)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_621- Disorders of uterus, not elsewhere classified\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e33.53(5.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e51.20(6.81)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_622- Noninflammatory disorders of cervix\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.13(6.83)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e48.19(6.66)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_623- Noninflammatory disorders of vagina\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.89(7.00)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e49.63(7.78)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_624- Noninflammatory disorders of vulva and perineum\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_625- Pain and other symptoms associated with female genital organs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.86(6.27)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e45.69(4.52)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_626- Disorders of menstruation and other abnormal bleeding from female\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e715\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e30.20(6.87)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e175\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e46.78(4.68)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_627- Menopausal and postmenopausal disorders\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e9\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e35.33(4.72)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e123\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.30\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e55.24(5.97)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_628- Infertility, female\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e32.20(5.45)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_629- Other disorders of female genital organs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31.33(7.71)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAmong them, in ICD-9 600\u0026ndash;608 men reproductive organ diseases, those aged\u0026thinsp;\u0026le;\u0026thinsp;40 years accounted for 1.03% (441 people), with an average age of 33.32 years (SD: 5.64); those aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years accounted for 4.11% (1,660 people), with an average age of 56.90 years (SD: 9.97).\u003c/p\u003e\n\u003cdiv class=\"Heading\"\u003e\u003cb\u003eProstatic hyperplasia (ICD-9 600)\u003c/b\u003e:\u003c/div\u003e\u003cp\u003eThose aged\u0026thinsp;\u0026le;\u0026thinsp;40 years accounted for 0.28% (118 people), with an average age of 35.82 years (SD: 4.12). Those aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years accounted for 3.40% (1,371 people), with an average age of 58.39 years (SD: 9.83).\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eInflammatory diseases of the prostate (ICD-9 601):\u003c/h2\u003e\u003cp\u003eThose aged\u0026thinsp;\u0026le;\u0026thinsp;40 years accounted for 0.12% (53 people), with an average age of 34.81 years (SD: 4.32). Those aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years accounted for 0.22% (90 people), with an average age of 54.53 years (SD: 11.02). Other prostate diseases (ICD-9 602) occurred mainly in patients\u0026thinsp;\u0026gt;\u0026thinsp;40 years old (0.02%), with a mean age of 62.30 years (SD: 7.86).\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eIn ICD-9 614–616 Inflammatory disorders of the female pelvic organs:\u003c/h3\u003e\n\u003cp\u003eThose aged\u0026thinsp;\u0026le;\u0026thinsp;40 years accounted for 1.54% (657 people), with an average age of 30.04 years (standard deviation: 7.80). Those aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years accounted for 0.60% (243 people), with an average age of 48.64 years (SD: 6.63).\u003c/p\u003e\n\u003ch3\u003eIn ICD-9 617–629 Other female reproductive system disorders:\u003c/h3\u003e\n\u003cp\u003eThose aged\u0026thinsp;\u0026le;\u0026thinsp;40 years accounted for 2.25% (960 people), with an average age of 30.59 years (SD: 6.97). Those aged\u0026thinsp;\u0026gt;\u0026thinsp;40 years accounted for 1.01% (408 people), with an average age of 49.25 years (SD: 6.63).\u003c/p\u003e\u003cp\u003eIn general, subjects over 40 years old had a higher incidence of reproductive system-related diseases, and their average age was significantly higher than that of the group under 40 years old. Among them, prostate-related diseases are more common in older men, while women reproductive system diseases are more widely distributed but still mostly occur in older people.\u003c/p\u003e\u003cp\u003eThe prevalence of the most common diseases of the reproductive system among prisoners by age group is shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. The diseases with the highest prevalence were hyperplasia of the prostate (1.79%), disorders of menstruation and other abnormal bleeding from women (1.07%), and inflammatory diseases of the cervix, vagina, and vulva (0.92%). Overall, 4.98% of prisoners had diseases of the reproductive system. Prisoners older than 40 years had a significantly higher prevalence of reproductive system diseases (5.60%) compared to those 40 years old or younger (4.40%) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). Among male prisoners, hyperplasia of the prostate was significantly more common in those older than 40 years (3.40%) compared to those aged 40 or younger (0.28%) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). For women prisoners, inflammatory diseases of the cervix, vagina, and vulva were more prevalent in those aged 40 or younger (1.31%) compared to those older than 40 (0.50%) (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). Similarly, pain and other symptoms associated with women genital organs (0.37% vs. 0.16%) and disorders of menstruation and other abnormal bleeding (1.68% vs. 0.43%) were significantly more common in the younger age group (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.0001).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThe prevalence of most common diseases of the reproductive system among prisoners by age group (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;83,048, Taiwan, 2013)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;40\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;40\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cem\u003ep\u003c/em\u003e for χ\u003csup\u003e2\u003c/sup\u003e test\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e%\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eTotal prisoners\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8643\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e74405\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e89.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_580\u0026ndash;599 Diseases of the reproductive system\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1878\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2259\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_600- Hyperplasia of prostate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e118\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1371\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3.40\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_604- Orchitis and epididymitis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e733\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.1467\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_607- Disorders of penis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e139\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.2368\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFemale\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_616- Inflammatory disease of cervix, vagina, and vulva\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e560\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_625- Pain and other symptoms associated with female genital organs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.37\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.16\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eICD9_626- Disorders of menstruation and other abnormal bleeding from female\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e715\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e175\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study aimed to explore the age distribution and sex differences in reproductive system diseases among prisoners. The results showed that age had a significant impact on the incidence of reproductive system diseases, especially for prisoners over 40 years old. This finding is consistent with previous studies indicating that older age groups generally face higher reproductive health risks [\u003cspan additionalcitationids=\"CR31 CR32\" citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e].\u003c/p\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eCorrelation between sex, age and reproductive system diseases\u003c/h2\u003e\u003cp\u003eThis study found that age was significantly associated with the incidence of reproductive system diseases among the prisoner population. In particular, prisoners aged 40 years and above (both men and women) had a higher incidence of reproductive system diseases than prisoners under 40 years old, a finding consistent with previous related research results [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]. These results highlight the importance of age in disease progression, particularly in prostate-related diseases in men, where increasing age shows a strong association with disease [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Many studies have pointed out that the incidence of diseases such as prostatic hyperplasia and prostatitis in men increases significantly with age [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e]. In addition, for women prisoners, although problems such as menstrual abnormalities and vaginal inflammation are more common among younger prisoners, female prisoners over 40 years old still show a higher risk of reproductive health problems [\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eIn terms of sex differences, this study found significant differences in the distribution of reproductive health diseases between men and women prisoners. For male prisoners, the incidence of prostate hyperplasia is as high as 3.40% in the group over 40 years old, while it is only 0.28% in the group under 40 years old. This result is consistent with the incidence pattern of prostate disease, with older men generally facing more prostate-related health problems [\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e]. However, for women prisoners, menstrual abnormalities, painful symptoms and other problems related to the women reproductive organs are more common in the group under 40 years old. These outcomes may be related to hormonal changes, infection risk, and lifestyle in young women, factors that may be further exacerbated in the prison environment [\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eHealthcare implications\u003c/h2\u003e\u003cp\u003eIn terms of the number of times they received medical services each year, women prisoners had a higher frequency of visits (18.17 times) than men prisoners (13.27 times), which indicates that women prisoners have a higher demand for medical care in terms of reproductive health issues. This finding may reflect the increased reproductive health problems faced by women prisoners, especially those related to menstrual abnormalities, vaginal inflammation, etc [\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e]. Nevertheless, prisoners with reproductive system diseases (regardless of sex) show a higher frequency of medical visits, which emphasizes the importance of focusing on specific disease groups and allocating medical resources [\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e]. In addition, older prisoners, especially men, tend to have more health problems and therefore their medical needs increase significantly [\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e]. This also reminds the prison medical system that it needs to take into account the age structure and health status of prisoners when allocating resources in order to provide appropriate treatment and preventive measures more effectively [\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eThe impact of the prison environment on prisoners' health cannot be ignored. Factors such as living conditions, medical facilities, and social support systems in Taiwan\u0026rsquo;s prisons may exacerbate prisoners\u0026rsquo; health problems. Many studies have shown that health problems among prisoners are often affected by prison living conditions, including stress, malnutrition, lack of adequate exercise and medical care [\u003cspan additionalcitationids=\"CR45 CR46 CR47\" citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR48\" class=\"CitationRef\"\u003e48\u003c/span\u003e]. In addition, there may be unequal distribution of medical resources and service quality in prisons, which may prevent certain groups of prisoners (such as women and the elderly) from receiving necessary health examinations and treatment in a timely manner [\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e49\u003c/span\u003e]. Improving health care in prisons, especially for groups of prisoners with special health needs (such as those with reproductive system conditions), is crucial to improving the overall health of prisoners [\u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec14\" class=\"Section2\"\u003e\u003ch2\u003eFuture research directions\u003c/h2\u003e\u003cp\u003eAlthough this study provides rich data and valuable insights, there are still several aspects that deserve further exploration. Firstly, the cross-sectional design of this study cannot determine the causal relationship of disease development, and future longitudinal studies should be conducted to track health changes in prisoners and identify possible risk factors. Secondly, comparative studies of different prison settings can help to understand how factors such as living conditions, medical services, and psychological support affect the health of prisoners. Finally, considering the possible existence of multiple comorbidities in the prisoner population, future research could comprehensively consider more diseases related to reproductive health and explore their interrelationships.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eMethodological considerations\u003c/h2\u003e\u003cp\u003eThere were several strengths in this study. Firstly, large sample size: this study covers a large sample of prisoners, which makes the research results highly representative and statistically significant. The number of prisoners included in the study (\u003cem\u003en\u003c/em\u003e\u0026thinsp;=\u0026thinsp;83,048) is unmatched by most related literature, providing a comprehensive understanding of the health status of the entire prison population. Secondly, detailed age and sex stratification: This study explored in depth the impact of age and sex on reproductive system diseases and compared two age groups, those aged 40 and above and those aged 40 and below. Such stratification helps to reveal health differences among different groups and to provide specific medical recommendations based on the needs of different groups. Thirdly, subdivision of disease categories: the study conducted a detailed classification of reproductive system diseases (such as prostate hyperplasia, menstrual abnormalities, etc.), which made the results not limited to the prevalence of overall diseases but went deep into the distribution characteristics of each specific disease, which has a great reference value for subsequent medical interventions. Finally, comprehensive data analysis: the research data sources include multi-dimensional data such as the number of medical services and disease incidence, so that the research results can evaluate the health status of prisoners from different angles. This multivariate analysis method helps to fully understand the reproductive health issues of prisoners.\u003c/p\u003e\u003cp\u003eIt must be acknowledged that this study has some limitations. Firstly, cross-sectional design: This study was cross-sectional and could not establish causality. Although a correlation between age and reproductive system diseases was found, it is not possible to determine whether age directly causes the development of reproductive system diseases. Future longitudinal studies will help to further validate these associations. Secondly, data source limitations: The data used in this study came from the prison system, which may limit the representativeness of the sample. The health status of prisoners may be affected by multiple factors such as prison living conditions and psychological stress, which may differ significantly from the health status of the general population. Therefore, the findings may not be fully applicable to non-prisoner populations. Thirdly, other health factors are not considered: This study focused on reproductive diseases, but prisoners\u0026rsquo; health is often related to a variety of factors, such as mental health problems, nutritional status, chronic diseases, etc. Failure to consider these potential comorbid conditions may affect disease morbidity and treatment outcomes. Fourthly, Lack of data on lifestyle and socioeconomic factors: The health status of prisoners may be closely related to their lifestyle and socioeconomic background, but these factors were not analyzed in detail in this study. For example, lifestyle factors such as smoking, alcohol consumption, and poor nutrition may have an impact on the reproductive health of prisoners, and these unaccounted-for variables may bias the study results. Finally, Lack of random sampling: The study sample was drawn from a specific prison system and was not randomly sampled, so there may be selection bias. The health status of prisoners is affected by the prison environment, which is different from the situation of the general social group. In the future, random sampling can be considered in more prison systems to improve the external validity of the study.\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study analyzed reproductive system diseases and their age and sex differences in the Taiwanese prison population and proposed age-stratified medical service recommendations. Although the results reveal the impact of age and sex on the disease, further longitudinal studies are still needed to explore causal relationships and long-term development trends of the disease. In order to effectively respond to the diversity of health problems among prisoners, the prison medical system should adjust service strategies according to the age, sex and health status of prisoners, thereby improving the effectiveness of reproductive health management for prisoners.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eY-HT, Y-P Y, Y-CH, and T-HT performed the study and drafted the manuscript. Y-CW and C-YT designed the study and performed data synthesis. T-HT conceived the study and participated in its design and coordination. All authors have read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere was no additional financial support from public or private sources.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved\u0026nbsp;by the\u0026nbsp;Institutional Review Board Research Ethics Committee of Taizhou Hospital of Zhejiang Province (TZH-IRB: K20240836).\u0026nbsp;All methods were performed in accordance with the relevant guidelines and regulations stipulated in the Declaration of Helsinki.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCloud DH, Garcia-Grossman IR, Armstrong A, Williams B. 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PLoS One. 2021 May 11;16(5):e0251364. https://doi.org/10.1371/journal.pone.0251364 \u003c/li\u003e\n\u003cli\u003eLead, A. P. H. A. (2020). Advancing public health interventions to address the harms of the carceral system. American Public Health Association.\u003c/li\u003e\n\u003cli\u003eIsasi F, Naylor MD, Skorton D, Grabowski DC, Hern\u0026aacute;ndez S, Rice VM. Patients, Families, and Communities COVID-19 Impact Assessment: Lessons Learned and Compelling Needs. NAM Perspect. 2021 Nov 29; 2021:10.31478/202111c. https://doi.org/10.31478/202111c \u003c/li\u003e\n\u003cli\u003eones CH, Dolsten M. Healthcare on the brink: navigating the challenges of an aging society in the United States. NPJ Aging. 2024 Apr 6;10(1):22. doi: 10.1038/s41514-024-00148-2. Erratum in: NPJ Aging. 2024 May 10;10(1):25. https://doi.org/10.1038/s41514-024-00153-5 \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Taiwanese prisoners, prison, reproductive system diseases, sex difference","lastPublishedDoi":"10.21203/rs.3.rs-6975608/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6975608/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThe prevalence of reproductive system diseases among prisoners in Taiwan has not been extensively studied. This study aimed to estimate the sex-specific prevalence of reproductive system diseases in a sample of Taiwanese prisoners.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe included data from 84,048 prisoners, obtained from the National Health Insurance (NHI) Program. Outcomes were measured using the clinical version of the International Classification of Diseases, Ninth Revision (ICD-9-CM). Prevalence rates were calculated in terms of absolute values and percentages. A χ2 test was performed to assess sex and age group differences in the percentage of reproductive system diseases.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe overall prevalence rate of reproductive system diseases among Taiwanese prisoners was 4.98%, which was higher than that of the general population. The prevalence was significantly higher in male prisoners compared to female prisoners (p\u0026thinsp;\u0026lt;\u0026thinsp;0.0001). The three most prevalent reproductive system diseases were benign prostatic hyperplasia (1.79%), disorders of menstruation and other abnormal bleeding (1.07%), and inflammatory diseases of the cervix, vagina, and vulva (0.92%). The prevalence of these diseases was significantly higher in men prisoners compared to women prisoners, with men prisoners exhibiting higher rates of prostate-related diseases, while women prisoners had higher rates of menstrual and pelvic disorders.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eReproductive system diseases are common among Taiwanese prisoners, highlighting the need for early prevention and appropriate treatment. Sex-specific healthcare strategies are essential due to the differences in the prevalence of reproductive system diseases between male and female prisoners.\u003c/p\u003e","manuscriptTitle":"Prevalence of Reproductive System Diseases Among Taiwanese Prisoners: A Population-Based Study on Sex and Age Differences","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-11 08:57:19","doi":"10.21203/rs.3.rs-6975608/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"154358c7-1c97-459d-8e8b-59f5dece8f2e","owner":[],"postedDate":"July 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-13T06:53:32+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-11 08:57:19","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6975608","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6975608","identity":"rs-6975608","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}