Kuh D, Stirling S
Medical Research Council National Survey of Health and Development, University College London Medical School, Department of Epidemiology and Public Health, London.
BMJ. 1995 Sep 30;311(7009):840-3. doi: 10.1136/bmj.311.7009.840.
To investigate socioeconomic variation among young women in the risk of hospital admission for diseases (including neoplasms) of the female genital system and breast and for the common surgical procedures of dilatation and curettage and hysterectomy.
Large nationally representative cohort study with individual records of confirmed admissions to NHS and private hospitals since birth and data on occupational and educational experience.
England, Scotland, and Wales.
General population sample of 1628 women, 1549 of whom had a complete admissions record for the ages of 15-43 years.
The percentage of women admitted for neoplasms or other diseases of the female genital system and breast or who had dilatation and curettage or hysterectomy between the ages of 15 and 43 years.
By the age of 43, 35% of women had been admitted, 17% had undergone dilatation and curettage at least once, and 10% had had a hysterectomy. There were significant inverse educational gradients, the risk of admission increasing more than twofold between the most and least educated women. The differential risk was most striking for disorders of menstruation, in which only 1% of those with the highest educational qualifications and 19% of those with minimal qualifications had been admitted to hospital. There was a significant educational gradient in the hysterectomy rate (from 1% to 15%) and a twofold difference in the risk of dilatation and curettage. There were also significant gradients in risk of admission and of hysterectomy according to partner's social class.
Socioeconomic variations in the risk of dilatation and curettage and of hysterectomy were large. Lessening the socioeconomic gradient in risks of admissions and surgery for diseases of the female genital system and breast, particularly for menstrual disorders, could have important resource implications.
调查年轻女性在因女性生殖系统和乳腺疾病（包括肿瘤）以及刮宫术和子宫切除术等常见外科手术而住院风险方面的社会经济差异。
具有全国代表性的大型队列研究，包含自出生以来在国民保健服务（NHS）和私立医院确诊入院的个人记录以及职业和教育经历数据。
英格兰、苏格兰和威尔士。
1628名女性的一般人群样本，其中1549人有15至43岁的完整入院记录。
15至43岁之间因女性生殖系统和乳腺肿瘤或其他疾病入院或接受刮宫术或子宫切除术的女性百分比。
到43岁时，35%的女性曾入院，17%的女性至少接受过一次刮宫术，10%的女性做过子宫切除术。存在显著的教育程度反向梯度，受教育程度最高和最低的女性之间入院风险增加了两倍多。月经紊乱方面的差异风险最为显著，其中最高学历者中只有1%入院，而最低学历者中有19%入院。子宫切除率存在显著的教育梯度（从1%到15%），刮宫术风险存在两倍差异。根据伴侣的社会阶层，入院风险和子宫切除风险也存在显著梯度。
刮宫术和子宫切除风险的社会经济差异很大。缩小女性生殖系统和乳腺疾病，尤其是月经紊乱疾病的入院和手术风险方面的社会经济梯度，可能会对资源产生重要影响。
