Hysterectomy Among Women of Reproductive Age: Trends in the United States, 1970–1978

ABSTRACTSThis article provides a detailed analysis of the trends in hysterectomy among women aged 15 to 44 years from 1970 to 1978 and the influence of age, race, and geographic region on hysterectomy rates, surgical approach, and concurrent oophorectomy.Data used in this study were collected by the National Center for Health Statistics (NCHS) as part of the ongoing National Hospital Discharge Survey.For this report, the authors analyzed data for women aged 15 to 44 years who had hysterectomies between 1970 and 1978.To control for the possible confounding effects of age, race, and region, all rates and proportions were standardized by these variables. Rates were directly adjusted using the pooled population of women aged 15 to 44 years each year from 1970 to 1978 as the standard. Mean ages were directly standardized by region and race using the total number of women 15 to 44 years old undergoing hysterectomy between 1970 and 1978 as the standard population.During the 9-year period of 1970 to 1978, an estimated 3,536,000 women between the ages of 15 and 44 years underwent hysterectomy (excluding radical procedures) in U.S. non-federal, short-stay hospitals. Between 1970 and 1972, the number of hysterectomies increased by 28 per cent from 306,000 to 391,000. Between 1973 and 1978, the number remained almost constant, ranging from 403,000 to 442,000 per year. The hysterectomy rate averaged 8.5 per 1,000 women aged 15 to 44 years during the study period.In every year, hysterectomy rates were lowest for the youngest age group and highest for the oldest age group. Rates for women younger than 25 years remained virtually constant at about one per 1,000 throughout the study period. Rates for women aged 25 to 34 years averaged 10.3 per 1,000; rates for women aged 35 to 44 years averaged 18.4. For the entire period, the mean age of women undergoing hysterectomy averaged 35.1 years ranging from 35.6 years in 1970 to 34.6 in 1977.Rates were consistently highest for women in the South and consistently lowest for women in the Northeast. Since 1974, the hysterectomy rates in the South have been more than twice those in the Northeast.Within each region, 1970 to 1978 hysterectomy rates increased with age. In every age group, rates were lowest for women in the Northeast and highest for women in the South. Women undergoing hysterectomy in the Northeast had the highest mean age for each year studied, with an average age of 37.0 years, while women in the South had the lowest m