Predictors of hysterectomy: An Australian study☆,☆☆,★
Section snippets
Sample
Participants were members of a cohort of 1979 female twin pairs, ascertained originally in 1980 to 1982 from the Australian Twin Register, and followed up in 1988 to 1990.1, 2 The current study comprised a third wave of data collection from the original cohort of female twins. In 1993 to 1994 questionnaires that focused on gynecologic conditions and hysterectomy were sent to both members of 1570 female twin pairs plus a further 158 individual female twins in incomplete pairs (3298 individuals)
Response
A total of 3096 women returned a questionnaire that was at least partially completed, giving an individual response rate of 94%. The respondents comprised 1431 pairs where both cotwins responded and 234 single twins, a pairwise response rate of 91%. Major reasons for nonresponse were death (n = 24) or they were uncontactable (n = 93) or too busy to participate (n = 76).
Of women reporting hysterectomy (n = 524), 439 (86%) gave consent to approach relevant physicians and response was obtained
Comment
The aim of this component of our research was to identify predictors of hysterectomy from an epidemiologic rather than a clinical sample. Our findings affirmed that women accurately reported hysterectomy; there were few true inconsistencies between women’s and physicians’ reports. Careful checking revealed very few reasons why the patient’s report should not be accepted and suggested that the physician’s negative response in some cases may have substituted for not knowing the patient’s
Acknowledgements
We thank Olivia Zheng, Ann Eldridge, Lorna Greenwood, Theresa Pangan, Petra Kuhnert, Gu Zhu, and John Pearson for research and computing assistance.
References (37)
- et al.
Pathways to hysterectomy: insights from longitudinal twin research
Am J Obstet Gynecol
(1992) - et al.
Clinical indications for hysterectomy route: patient characteristics or physician preference?
Am J Obstet Gynecol
(1995) Shifting indications for hysterectomy: nature, nurture, or neither?
Lancet
(1994)- et al.
Five gynecologic diagnoses associated with hysterectomy—trends in incidence of hospitalizations in Finland, 1971-1986
Maturitas
(1994) - et al.
Complications of abdominal and vaginal hysterectomy among women of reproductive age in the United States
Am J Obstet Gynecol
(1982) - et al.
Hysterectomies: where are the indications?
Obstet Gynecol Clin North Am
(1994) - et al.
Hysterectomy in Danish women: weight-related factors, psychologic factors, and life-style variables
Obstet Gynecol
(1996) - et al.
Longitudinal genetic analysis of menstrual flow, pain and limitation in a sample of Australian twins
Behav Genet
(1998) SAS/STAT user’s guide version 6 edition
(1997)- et al.
Classification and regression trees
(1994)
Reproducibility and validity of self-reported menopausal status in a prospective cohort study
Am J Epidemiol
Hysterectomy use: the correspondence between self-reports and hospital records
Am J Public Health
Changing hysterectomy patterns after introduction of laparoscopically assisted vaginal hysterectomy
Am J Obstet Gynecol
A matter of opinion about hysterectomies: experts’ and practicing community gynecologists’ ratings of appropriateness
Am J Public Health
The impact of nonclinical factors on practice variations: the case of hysterectomies
Health Serv Res
Indications for hysterectomy: have they changed?
Clin Obstet Gynecol
The epidemiology of hysterectomy: findings in a large cohort study
Br J Obstet Gynaecol
Indications for and outcome of total abdominal hysterectomy for benign disease: a prospective cohort study
Br J Obstet Gynaecol
Cited by (53)
Hysterectomy risk in premenopausal-aged military veterans: Associations with sexual assault and gynecologic symptoms
2016, American Journal of Obstetrics and GynecologyCitation Excerpt :Reasons for hysterectomy were self-reported by our sample vs extracted from the medical records in the NSQIP sample. Treloar et al59 found the validity of self-reported reasons for hysterectomy to be variable when comparing patient report with physician report. Agreement between patient and physician was poor when the reason described was fibroids, menorrhagia, and dysmenorrhea but was better for endometriosis, pelvic organ prolapse, and ovarian cancer.
Common variants in the CYP2C19 gene are associated with susceptibility to endometriosis
2014, Fertility and SterilityCitation Excerpt :A surgical diagnosis was confirmed by retrospective examination of medical records; disease severity was determined using the revised American Fertility Society (rAFS) classification system (18). Control samples comprised unrelated individuals originally recruited through QIMR Berghofer for either a twin study of gynecological health who self-reported no endometriosis (discovery sample) (4) or the sample previously used for our endometriosis GWAS (replication sample) (5) recruited through the Brisbane Adolescent Twin Study (19, 20). Approval for this study and to obtain medical records, for collection of blood for DNA extraction and all questionnaires and interview schedules and for the inclusion of twin individuals recruited through the Australian Twin Registry, was obtained from the QIMR Berghofer Human Research Ethics Committee.
Prevalence and knowledge of heavy menstrual bleeding among African American women
2014, International Journal of Gynecology and ObstetricsCitation Excerpt :Although more than 40% of premenopausal women described their menses as “heavy” or “very heavy,” only one-third of participants reported receiving treatment for HMB. One reason that women may not pursue care is that gynecologic consultation is perceived as being a step toward obtaining a hysterectomy [22]. Known cultural norms surrounding menstruation may be another contributing factor to African American women not seeking care for HMB because some African American women regard their menses as a needed anatomic cleansing process [23].
Genome-wide linkage and association analyses implicate FASN in predisposition to uterine leiomyomata
2012, American Journal of Human GeneticsCitation Excerpt :Individuals composing the cohort from the Queensland Institute of Medical Research (QIMR) were women who had given consent and who had been genotyped previously on Illumina’s 317K, 370K, or 610K SNP platforms as part of a larger collection of genome-wide association studies conducted at the QIMR.18,19 Case samples (n = 484) were selected from among women originally recruited into a study of genetic factors underlying endometriosis20 and a twin study of gynecological health.21 For both studies, women completed questionnaires on various aspects of reproductive health, and cases answered “yes” to the “uterine fibroids” option of the question “Have you ever had any of the following conditions?”
Factors associated with age of onset and type of menopause in a cohort of UK women
2011, American Journal of Obstetrics and GynecologyHigh-density fine-mapping of a chromosome 10q26 linkage peak suggests association between endometriosis and variants close to CYP2C19
2011, Fertility and SterilityCitation Excerpt :An additional 40 QIMR cases were chosen from families not included in the original linkage analysis but containing a proband plus at least two affected relatives using the same criteria. The QIMR controls (N = 952) were chosen from female twin pairs originally recruited for a study of gynecological health (15), including one sample from pairs where neither sister had self-reported endometriosis. Oxford controls (N = 238) were unrelated women recruited in collaborating hospitals who were [1] undergoing laparoscopy for pelvic pain, subfertility, or other gynecological complaints, hysterectomy, or sterilization; [2] free of endometriosis at surgery, and [3] without a previous surgical diagnosis of endometriosis.
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Supported by the Mayne Bequest Fund (University of Queensland) and the Australian Gynaecological Endoscopy Society.
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Reprint requests: S.A. Treloar, PhD, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Queensland 4029, Australia.
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0002-9378/99 $8.00 + 0 6/1/96055