Trends in Hysterectomy Incidence Rates During 2000–2015 in Denmark: Shifting from Abdominal to Minimally Invasive Surgical Procedures

• Main Authors: Lycke KD, Kahlert J, Damgaard R, Mogensen O, Hammer A
• Format: Article
• Language: English
• Published: Dove Medical Press 2021-06-01
• Series: Clinical Epidemiology
• Subjects: hysterectomy; incidence; surgical procedure; indication; epidemiology
• Online Access: https://www.dovepress.com/trends-in-hysterectomy-incidence-rates-during-20002015-in-denmark-shif-peer-reviewed-fulltext-article-CLEP

Kathrine Dyhr Lycke,1,2 Johnny Kahlert,3 Rikke Damgaard,1,2 Ole Mogensen,2,4 Anne Hammer1,2,4 1Department of Obstetrics and Gynecology, NIDO | Denmark, Gødstrup Hospital, Herning, Denmark; 2Department of Clinical Medicine, Aarhus University, Aarhus, Denmark; 3Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 4Department of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, DenmarkCorrespondence: Kathrine Dyhr LyckeDepartment of Obstetrics and Gynecology, NIDO | Denmark, Gødstrup Hospital, Gl. Landevej 61, Herning, DK-7400, DenmarkEmail [e-mail]: Hysterectomy (removal of the uterus) is a common surgical procedure in gynecology. Although minimally invasive surgical procedures have been introduced, hysterectomy is still associated with risk of short- and long-term complications. Given that hysterectomized women are no longer at risk of either hysterectomy or being diagnosed with endometrial or cervical cancer, it is important to describe trends in hysterectomy rates.Objective: To describe trends in hysterectomy incidence rates overall and stratified by age, indication, and procedure.Methods: Nationwide population-based cohort study using Danish national registries, 2000– 2015, was conducted. We calculated the overall hysterectomy-corrected and age-standardized incidence rates of hysterectomy among women ≥ 20 years old. Incidence rates were stratified by age group, indication, and surgical procedure. We performed trend analyses using Joinpoint regression, thereby estimating the average annual percentage change (AAPC).Results: A total of 98,484 women had a hysterectomy during the study period, corresponding to an overall age-standardized, hysterectomy-corrected hysterectomy incidence rate (SIR) of 351.1 per 100,000 person-years (95% CI 348.9;353.3). SIR of hysterectomy declined over time (AAPC − 1.4; 95% CI − 1.9;-1.0), which was driven by a decline in rates of benign hysterectomy (AAPC − 2.1; 95% CI − 2.7;-1.6). Irrespective of indication, rates of abdominal hysterectomy declined substantially during the study period and were surpassed by rates of minimally invasive procedures (ie, laparoscopy and robot-assisted laparoscopy) in 2013.Conclusion: Hysterectomy-corrected incidence rates of benign hysterectomy declined over time. Irrespective of indication, we observed a shift in surgical procedure over time, from abdominal hysterectomy to minimally invasive surgical procedures.Keywords: hysterectomy, incidence, surgical procedure, indication, epidemiology