Global epidemiology of hysterectomy: possible impact on gynecological cancer rates.
Despite the fact that hysterectomy is the most common surgical procedure worldwide in gynecology, national reporting of the incidence rate of gynecological cancers rarely removes the proportion no longer at risk of the disease from the population-at-risk-denominator (ie, women who have had a hysterectomy). The incidence rate of gynecological cancers is thus likely underestimated. Because hysterectomy, as well as oophorectomy, incidence varies across countries, age, and over time, meaningful comparison of gynecological cancer incidence rates may be compromised. Without accurate estimates of gynecological cancer incidence rates, performed via removing the proportion of hysterectomized or oophorectomized women from the population-at-risk-denominator, the impact of prevention strategies may be masked or misinterpreted. Furthermore, because national cervical cancer screening guidelines are at least in part based on the national reporting of cervical cancer incidence, it is important that the incidence rate reflects the true population at risk.
Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: ahlauridsen@clin.au.dk.
Anne
A
Hammer
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
Anne F
AF
Rositch
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Johnny
J
Kahlert
Department of Pathology, University of New Mexico Health Science Center, Albuquerque, NM.
Patti E
PE
Gravitt
Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark.
Jan
J
Blaakaer
Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark.
Mette
M
Søgaard
D005060:Europe / Q000453:epidemiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology*; D014943:Global Health; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D015994:Incidence; D009656:North America / Q000453:epidemiology; D010052:Ovariectomy / Q000706:statistics & numerical data; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears
cervical cancer screening; epidemiology; gynecological cancer; hysterectomy