Racial disparities in non-hysterectomy surgeries for endometriosis

Tarangi Sutaria, Katherine Freedy, Lisa Flowers, Marie E. Shockley, Danielle Blemur, W.A. Barnes, Mark Lachiewicz
In: Journal of Endometriosis and Uterine Disorders · 2025 · vol. 11 , pp. 100124 · doi:10.1016/j.jeud.2025.100124 · W4411276388
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White patients were more likely than Black patients to receive non-hysterectomy surgeries for endometriosis, a disparity not explained by socioeconomic factors.

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Abstract

• Assessing Racial Disparities in Endometriosis Surgery Type: This study is the first of its kind in that it analyzes differences surgical treatment for endometriosis among race/ethnicity groups. • Racial Disparities in Surgery : White patients had significantly higher odds of receiving non-hysterectomy surgeries for endometriosis compared to Black patients, even after adjusting for confounding factors. • Socioeconomic Factors and Surgery : Patients who underwent hysterectomy for endometriosis were more likely to experience poverty, though poverty did not account for racial disparities in non-hysterectomy surgery rates. • Need for Further Investigation : The study highlights the need to explore factors that may influence surgical decision-making and contribute to racial disparities in endometriosis treatment, including systemic racism in medicine. To evaluate the self-reported prevalence of hysterectomy and non-hysterectomy surgeries for endometriosis by race/ethnicity. This cross-sectional study used data from the National Survey of Family Growth (NSFG) 2017-2019 cycle. This study included persons ages 15-49 years who identify as female and who reported receiving a diagnosis of endometriosis from a healthcare professional. The main study outcomes were self-reported receipt of hysterectomy and non-hysterectomy surgeries for endometriosis. The main exposure was race/ethnicity. Multivariable logistic regression estimated adjusted prevalence odds ratios and 95% confidence intervals of hysterectomy and non-hysterectomy endometriosis surgery. Differences in social determinants of health (SDH) among women who did and did not receive non-hysterectomy endometriosis surgery were tested using chi-square analysis. Of 6,141 survey participants, 314 (5.11%) answered yes to ever being diagnosed with endometriosis. While there were no significant differences in the odds of having a hysterectomy for endometriosis when stratifying by race/ethnicity, Black women had a significantly lower odds of non-hysterectomy endometriosis surgery compared to White women. The analysis of SDH revealed a higher prevalence of poverty among women who did not receive non-hysterectomy endometriosis surgeries. However, including poverty in the multivariable logistic regression model did not alter racial disparity findings. White women have over four times higher odds of receiving non-hysterectomy endometriosis surgery compared to Black women in a fully adjusted model, which cannot be explained by a secondary analysis of SDH. Further examination of factors that may influence decisions on surgery for endometriosis will create a better understanding of disparities in endometriosis care.

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endometriosis

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