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Hysterectomy in the United States, 1965-84.

The prospect of undergoing major surgery is frightening to many people. Yet for about 37 per cent of all women, this prospect is a reality by the time they are 60 years old as a result ofa single procedure-hysterectomy. Of the 97 million women ages 15 years or older in the United States in 1985, about 18.5 million have had a hysterectomy. This information comes from a recent National Center for Health Statistics report on hysterectomies in the United States for the period 1965-84.' The estimates in this 20-year study are based primarily on data collected by the National Hospital Discharge Survey. In addition to NHDS data, a table in the report presents estimates ofhysterectomies in US military hospitals. With fewer than 2 per cent of all hysterectomies performed in these facilities, the NHDS accounts for almost all hysterectomies performed in the United States. The report provides estimates of hysterectomy by age, race, geographic region, diagnosis, surgical approach, and whether or not a bilateral oopherectomy was also performed. In addition, data from the NHDS were used to calculate the proportion ofwomen with intact uteri by age through 1984-an extension of work by Lyon and Gardner.2 To be as up to date as possible, some of the data presented here are for 1985, even though the cited report covers only the period through 1984. During the two decades 1965-84, about 12.5 million women in the United States had a hysterectomy. It was the most common major surgery each year until 1981 when the rise in births by cesarean section supplanted hysterectomy as number one. Hysterectomy remained the second most common major surgery from 1981 through 1985. The largest number of hysterectomies was in 1975 when there were 725,000, or 8.6 per 1,000 women 15 years of age or older. Since then the annual number and rate have declined slightly and leveled off to about 650,000 hysterectomies or 7 per 1,000 women in the 1980s (Figure 1). The average length of stay for women hospitalized for hysterectomy has decreased from about 12 days in 1965 to about seven days in 1984, consistent with a general reduction in average length of stay for all hospitalizations. This decrease was likely due to