title: Hysterectomy rates for benign conditions are declining in Lombardy, Italy: 1996-2010.
abstract: OBJECTIVE
  To analyse the hysterectomy rates (HR) temporal trends for gynecological benign conditions in Lombardy, Northern Italy.
  
  
  METHODS
  Since 1991, discharges from public or private hospitals have been registered in a standard form (Lombardy Region registry). Women aged ≥20 years, residing in Lombardy, who underwent hysterectomy for benign conditions, were included in the study. Admissions were codified according to the ICD-9 and ICD-10. HRs per 1000 women residing in Lombardy, of the same age class, were computed.
  
  
  RESULTS
  In 1996-2010, 143,045 hysterectomies were performed for benign indications. HR showed a declining trend (average annual percent change (AAPC) -2.9), mainly due to the falling number of total abdominal hysterectomies (AAPC -5.3). The most remarkable decrease was seen in women aged 45-54 years (HR 8.05 in 1996 and 4.83 in 2010). Leiomyoma was the most frequent indication in women aged <55 years, whereas in older patients it was uterine prolapse.
  
  
  CONCLUSIONS
  In 1996-2010, the frequency of hysterectomy in Lombardy fell markedly. This study confirms the declining trend in abdominal hysterectomies observed in most developed countries, though the surgical approaches to hysterectomy differ in different countries. In particular, in Lombardy the proportion of laparoscopically assisted vaginal hysterectomies, though increasing, is low.
authors.affiliation: Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Dipartimento di Science Cliniche e di Comunità, via Commenda 12, 20,122 Milano, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Parazzini
authors.affiliation: Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Dipartimento di Science Cliniche e di Comunità, via Commenda 12, 20,122 Milano, Italy. Electronic address: ed.ricci@libero.it.
authors.forename: Elena
authors.initials: E
authors.lastname: Ricci
authors.affiliation: Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Dipartimento di Science Cliniche e di Comunità, via Commenda 12, 20,122 Milano, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Bulfoni
authors.affiliation: Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Dipartimento di Science Cliniche e di Comunità, via Commenda 12, 20,122 Milano, Italy.
authors.forename: Sonia
authors.initials: S
authors.lastname: Cipriani
authors.affiliation: Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Dipartimento di Science Cliniche e di Comunità, via Commenda 12, 20,122 Milano, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Chiaffarino
authors.affiliation: Istituto di Ricerche Farmacologiche Mario Negri, Dipartimento di Scienze Cliniche e di Comunità, Sezione di Statistica Medica e Biometria "GA Maccacaro", Università degli Studi di Milano, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Malvezzi
authors.affiliation: Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Università degli Studi di Milano, Dipartimento di Science Cliniche e di Comunità, via Commenda 12, 20,122 Milano, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Frigerio
mesh_terms: D000328:Adult; D000368:Aged; D004715:Endometriosis / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data / Q000639:trends*; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000639:trends; D007889:Leiomyoma / Q000453:epidemiology* / Q000601:surgery; D008599:Menstruation Disturbances / Q000453:epidemiology / Q000601:surgery; D008875:Middle Aged; D012042:Registries; D014591:Uterine Diseases / Q000453:epidemiology / Q000601:surgery; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000601:surgery; D014596:Uterine Prolapse / Q000453:epidemiology / Q000601:surgery
keywords: Benign gynecological conditions; Epidemiology; Gender medicine; Hysterectomy rate; Time trend