Chair of Epidemiology, TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany.
Center for International Health, Ludwig Maximilian University of Munich (LMU), Munich, Germany.
BMC Public Health. 2023 Jan 11;23(1):84. doi: 10.1186/s12889-022-14916-w.
To assess the hysterectomy probability by calendar period and age, the overall and the age-specific prevalence of hysterectomy in women aged 30-65 years.
Baseline data (2005-2007) from the population-based MARZY study conducted in Mainz and Mainz-Bingen, Germany, were analysed. 6429 women aged 30-65 years were asked whether they had undergone a hysterectomy and the date and indication of the procedure. We calculated the 5-year age-specific prevalence of hysterectomy and estimated the probability of undergoing a hysterectomy combining two approaches: 1) Kaplan-Meier and 2) Inverse probability weighting (IPW). We assessed potential changes over calendar periods by simulating survival curves, having hysterectomy as the event, employing a Cox proportional hazard model.
Data on hysterectomy were available for 4719 women. Of these, 961 (20.4%) had undergone a hysterectomy between 1960 and 2006. The hysterectomy prevalence was highest among the 60-64 year-olds (40.7%). The IPW-corrected probability of having a hysterectomy up to the age of 65 years was 36.4%. The age-specific probability of hysterectomy increased from 0.1% (20-24 years), peaking at 45-49 years (7.8%) and declining thereafter to less than 5% among women aged 50 and older. Over time, women were hysterectomised at an increasingly older age. Most hysterectomies (86.7%) were done due to benign disease.
A shift to older age at hysterectomy with an advancing calendar period likely reflects changes in clinical practice in Germany.
Landesärztekammer Rheinland-Pfalz: 837.438.03 (4100).
为了评估按时间和年龄划分的子宫切除术概率，我们研究了年龄在 30-65 岁的女性中子宫切除术的总体和年龄特异性流行率。
我们对德国美因茨和美因茨-宾根开展的基于人群的 MARZY 研究的基线数据（2005-2007 年）进行了分析。6429 名年龄在 30-65 岁的女性被问及是否接受过子宫切除术以及手术日期和指征。我们计算了每 5 年的年龄特异性子宫切除术流行率，并采用两种方法结合估计接受子宫切除术的概率：1）Kaplan-Meier 法和 2）逆概率加权（Inverse probability weighting，IPW）法。我们通过模拟生存曲线来评估日历时间变化，将子宫切除术作为事件，采用 Cox 比例风险模型。
我们获得了 4719 名女性的子宫切除术数据。其中，1960 年至 2006 年间有 961 名（20.4%）接受了子宫切除术。60-64 岁年龄组的子宫切除术流行率最高（40.7%）。截至 65 岁时，经 IPW 校正的子宫切除术概率为 36.4%。子宫切除术的年龄特异性概率从 20-24 岁的 0.1%开始上升，在 45-49 岁时达到峰值（7.8%），此后在 50 岁及以上的女性中下降至 5%以下。随着时间的推移，女性接受子宫切除术的年龄越来越大。大多数子宫切除术（86.7%）是由于良性疾病进行的。
随着时间的推移，德国临床实践的变化可能导致子宫切除术年龄的推移。
莱茵兰-普法尔茨州医师协会：837.438.03（4100）。
