Decreasing utilization of hysterectomy: a population-based study in Olmsted County, Minnesota, 1965-2002.

Abstract

The purpose of this study was to assess temporal trends for hysterectomy among Olmsted County, Minnesota women. Using the Rochester Epidemiology Project database, we identified all county residents undergoing a hysterectomy in 1965-2002. Temporal changes in the utilization (incidence) rate, type, diagnostic indications, and age at surgery were assessed. Between 1965 and 2002, 6152 women had a hysterectomy alone, whereas 3126 women had, in addition, a pelvic floor repair; the age-adjusted utilization rate for hysterectomy alone and for combined procedures declined (P < .0001) by 13% and 63%, respectively. Except for subjects aged 75-85 years, this decline affected every age group. The distribution of vaginal (56%) and abdominal (44%) procedures differed across indications. Uterine leiomyomata, precancerous conditions, and genital prolapse accounted for 28%, 23%, and 12% of all procedures, respectively. Among community women, the utilization rate, age distribution, and indications for a hysterectomy changed substantially between 1965 and 2002.