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RESEARCH PRODUCT

Probability of hysterectomy in Germany

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Introduction Hysterectomy is the most common gynecological surgery in many industrialized countries. In Germany, the hysterectomy rate is high in comparison to other European countries. The aim of this analysis was to determine the distribution of age at hysterectomy as well as the age-specific probability of undergoing a hysterectomy between the ages of 0–64 in the German female population. Methods Analyses were based on data from the MARZY study, a prospective, randomized, population-based cohort study investigating early detection of cervical cancer in western Germany. At baseline, 6429 women were invited to attend cervical cancer screening. The distribution of age at hysterectomy as well as indications for hysterectomy was reported. Based on survival analysis, which accounts for censoring at the age of interview, and the inverse probability weighting (IPW) method, the age-specific probability of undergoing a hysterectomy was estimated. The IPW method corrected for missing date of hysterecomy. Simulated calendar-period specific survival curves (1939–1979, 1980–1989, 1990–1999, 2000–2006) were computed to show how age and calendar year determine the probability of undergoing a hysterectomy. Results Data on hysterectomy were available for 4719 women. Of these, 961 women (20.4%) had undergone a hysterectomy. The main indication for hysterectomy was uterine fibroids (48%). A total of 850 women (88.4%) reported a date when their hysterectomy had been performed. The highest proportion of women was hysterectomized between the ages of 40–44 (24.6%). The IPW corrected probability of having a hysterectomy between the ages of 0–64 was 0.354. The age-specific probability of hysterectomy was highest in the 45–49-year age group (0.078). The age-specific probability of hysterectomy decreased between the years 1939 to 2006. Conclusion Data from the MARZY study allowed valuable conclusions to be drawn about the distribution of age at hysterectomy as well as the age-specific probability of undergoing a hysterectomy in Germany.