title: Hysterectomy and Bilateral Salpingo-Oophorectomy: Variations by History of Military Service and Birth Cohort.
abstract: BACKGROUND
  Little is known about hysterectomy and bilateral salpingo-oophorectomy (BSO), which are associated with both health risks and benefits, among women Veterans.
  
  
  OBJECTIVE
  To compare the prevalence of hysterectomy with or without BSO, and early hysterectomy, between postmenopausal Veterans and non-Veterans.
  
  
  METHODS
  We used baseline data from the Women's Health Initiative Clinical Trial and Observational Study. Multinomial logistic regression models examined differences in the prevalence of hysterectomy (neither hysterectomy nor BSO, hysterectomy without BSO, and hysterectomy with BSO) between Veterans and non-Veterans. Generalized linear models were used to determine whether early hysterectomy (before age 40) differed between Veterans and non-Veterans. Analyses were stratified by birth cohort (<65, ≥65 years at enrollment).
  
  
  RESULTS
  The unadjusted prevalence of hysterectomy without BSO was similar among Veterans and non-Veterans in both birth cohorts (<65: 22% vs 21%; ≥65: 22% vs 21%). The unadjusted prevalence of hysterectomy with BSO was equivalent among Veterans and non-Veterans in the >65 cohort (21%), but higher among Veterans in the <65 cohort (22% vs 19%). In adjusted analyses, although no differences were observed in the >65 cohort, Veterans in the <65 cohort had higher odds of hysterectomy without BSO (odds ratio [OR] 1.18, 95% confidence interval [CI] 1.03, 1.36) and with BSO (OR 1.26, 95% CI 1.10, 1.45), as well as elevated risk of early hysterectomy (relative risk 1.32, 95% CI 1.19, 1.47), compared with non-Veterans.
  
  
  CONCLUSIONS
  Aging women Veterans may have higher prevalence of hysterectomy and BSO than non-Veterans. This information contributes to understanding the health needs and risks of women Veterans and can inform clinical practice and policy for this population.
authors.affiliation: Department of Obstetrics and Gynecology, University of Washington, Seattle. VA Puget Sound Health Care System, Health Services Research and Development (HSR&D), Seattle, Washington. lisa.callegari@va.gov.
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Callegari
authors.affiliation: VA Puget Sound Health Care System, Health Services Research and Development (HSR&D), Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle.
authors.forename: Kristen E
authors.initials: KE
authors.lastname: Gray
authors.affiliation: VA Office of Patient Care, Women's Health Services, Washington, DC. VA New York Harbor. Department of Obstetrics and Gynecology, New York University Langone School of Medicine. Department of Veterans Affairs, Veterans Health Administration, Washington, DC.
authors.forename: Laurie C
authors.initials: LC
authors.lastname: Zephyrin
authors.affiliation: Department of Epidemiology, University of Washington School of Public Health, Seattle.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Harrington
authors.affiliation: VA Boston Healthcare System, Massachusetts. Department of Medicine, Boston University School of Medicine, Massachusetts.
authors.forename: Megan R
authors.initials: MR
authors.lastname: Gerber
authors.affiliation: de Tornyay Center for Healthy Aging, University of Washington School of Nursing, Seattle. Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, Washington.
authors.forename: Barbara B
authors.initials: BB
authors.lastname: Cochrane
authors.affiliation: VA Palo Alto Health Care System, California. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, California.
authors.forename: Julie C
authors.initials: JC
authors.lastname: Weitlauf
authors.affiliation: VA HSR&D Center for the Study of Healthcare Innovation, Implementation and Policy, VA Greater Los Angeles Health Care System, California. Division of General Internal Medicine, David Geffen School of Medicine, University of California Los Angeles.
authors.forename: Bevanne
authors.initials: B
authors.lastname: Bean-Mayberry
authors.affiliation: VA Connecticut, West Haven. Division of General Internal Medicine, University of Connecticut, Farmington.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Bastian
authors.affiliation: VA Central Western Massachusetts, Leeds. University of Massachusetts Medical School, Worcester.
authors.forename: Kristin M
authors.initials: KM
authors.lastname: Mattocks
authors.affiliation: VA Office of Patient Care, Women's Health Services, Washington, DC. VA Connecticut Health Care System, New Haven.
authors.forename: Sally G
authors.initials: SG
authors.lastname: Haskell
authors.affiliation: VA Puget Sound Health Care System, Health Services Research and Development (HSR&D), Seattle, Washington. Department of Health Services, University of Washington School of Public Health, Seattle. VA Office of Patient Care, Women's Health Services, Washington, DC.
authors.forename: Jodie G
authors.initials: JG
authors.lastname: Katon
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D015988:Cohort Effect; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data*; D016015:Logistic Models; D008875:Middle Aged; D016017:Odds Ratio; D010052:Ovariectomy / Q000706:statistics & numerical data*; D015995:Prevalence; D058994:Salpingectomy / Q000706:statistics & numerical data*; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data*
keywords: Bilateral salpingo-oophorectomy; Hysterectomy; Women Veterans