Hysterectomy surveillance in the United States, 1997 through 2005

BACKGROUND: To identify patterns and trends in hysterectomy from 1997 through 2005. MATERIAL/METHODS: Analyses are based on hysterectomy prevalence data from the Behavior Risk Factor Surveillance System, hysterectomy incidence data from the National Hospital Discharge Survey, and population estimates from the US Census Bureau. RESULTS: Hysterectomy rates significantly decreased 1.9% per year between 1997 and 2005 (-0.5% for ages 18-44, -3.1% for ages 45-64, and -5.0% for ages 65 years and older). The estimated annual decrease in rates was significant in the Northeast (-2.9%), Northwest (-1.7%), and South (-2.6%), but not in the West. For hysterectomies performed among women ages 18-44 years, the percentage in 1997-98 compared with 2004-05 resulting from leiomyoma (fibroids) decreased (31.4% vs. 26.9%), from uterine bleeding increased (14.6% vs. 25.2%), from endometriosis decreased (17.3% in vs. 16.2%), and from pain increased (10.4% vs. 11.7%); the most common procedure, total abdominal hysterectomy, decreased (65.0% vs. 60.5%), the second most common procedure, vaginal hysterectomy, decreased (32.0% vs. 30.7%), and the third most common procedure, subtotal hysterectomy, increased (1.6% in 1997-98 and 7.5% in 2004-05). Decreases in hysterectomy rates occurred for most of the reproductive health conditions resulting in hysterectomy. Exceptions included pain and bleeding in the age group 18-44 and bleeding in the age group 45-64. An increase occurred in subtotal abdominal hysterectomy rates in each of the age groups. CONCLUSIONS: Continued monitoring of hysterectomy rates provides an indication of female reproductive health and how women are being treated for selected reproductive problems.