Clinical Edge

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Hysterectomy for Gynecologic Cancers

A look at racial disparities

Minimally invasive hysterectomy for gynecologic malignancies remains underused in the US, while racial disparities associated with use of minimally invasive hysterectomy for uterine and cervical cancers persists, according to a cross-sectional analysis of 46,450 hysterectomies gynecologic malignancy performed in the US in 2012. More than half of these hysterectomies were performed through the abdominal approach. The study revealed:

• 61% of hysterectomies were performed for uterine, 9% for cervical, 27% for ovarian cancer, and 3% for other gynecologic malignancies.

• Minimally invasive hysterectomy was used in 50% of uterine, 43% of cervical, and 8.5% of ovarian cancer cases.

• Black women had decreased odds of undergoing minimally invasive hysterectomy for uterine (OR=0.50), and cervical (OR=0.56) cancers.

• As compared with the Northeast, patients in the South (OR=0.72) were less likely to undergo minimally invasive hysterectomy for uterine cancer, whereas those in the West were more likely (OR=1.48).

Citation: Esselen KM, Vitonis A, Einarsson J, et al. Health care disparities in hysterectomy for gynecologic cancers. [Published online ahead of print October 5, 2015]. Obstet Genecol. doi: 10.1097/AOG.0000000000001088.