Nolan T F, Ory H W, Layde P M, Hughes J M, Greenspan J R
Am J Epidemiol. 1982 Nov;116(5):776-81. doi: 10.1093/oxfordjournals.aje.a113467.
The authors used data from the 1970 National Fertility Survey and Centers for Disease Control surveillance of surgical sterilizations to estimate the cumulative prevalences of hysterectomy and tubal sterilization among women of reproductive age in the United States between 1971 and 1978. In 1978, the cumulative prevalence rate of tubal sterilization was more than twice as high for women aged 15--44 years as it was in 1971 and at least three times as high for women under 30. Although the increase in the cumulative prevalence rate of hysterectomy was not as marked, by 1978, 19% of women aged 40--44 had undergone hysterectomy. The authors used the cumulative prevalence rate to estimate the population at risk for surgical sterilization, and calculated the corrected incidence rates for these procedures. While corrected incidence rates of tubal sterilization among women aged 15--44 doubled between 1971 and 1978, corrected hysterectomy rates remained stable. The largest age-specific increase in incidence rates of tubal sterilization was among women 40--44, with rates six times higher in 1978 than in 1971. These findings can be used to recompute incidence rates of endometrial and cervical cancers, abortions, and ectopic pregnancies, allowing more precise analysis of related trends.
作者利用1970年全国生育调查的数据以及疾病控制中心对外科绝育手术的监测数据,来估算1971年至1978年间美国育龄妇女中子宫切除术和输卵管绝育术的累积患病率。1978年,15至44岁女性的输卵管绝育术累积患病率比1971年高出两倍多,30岁以下女性的该患病率至少高出三倍。尽管子宫切除术的累积患病率增长并不显著,但到1978年,40至44岁的女性中有19%接受了子宫切除术。作者用累积患病率来估算有外科绝育手术风险的人群,并计算了这些手术的校正发病率。1971年至1978年间,15至44岁女性的输卵管绝育术校正发病率翻了一番,而子宫切除术的校正发病率则保持稳定。输卵管绝育术发病率按年龄划分增长幅度最大的是40至44岁的女性,1978年的发病率是1971年的六倍。这些研究结果可用于重新计算子宫内膜癌、宫颈癌、流产和异位妊娠的发病率,从而更精确地分析相关趋势。