Racial Disparities in Hysterectomy Route for Benign Disease: Examining Trends from 2007-2018 Using the NSQIP Database

Abstract

Study Objective To examine national trends among race/ethnicity and route of benign hysterectomy from 2007-2018. Design This cohort study from 2007-2018 was conducted using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database and included the 2014-2018 targeted hysterectomy files. Setting NSQIP is a nationally validated, outcomes-based program containing perioperative data. Patients or Participants Current Procedural Terminology codes identified women undergoing benign hysterectomy and perioperative data including race and ethnicity were obtained. To determine relative trends in hysterectomy among racial cohorts (White, Black, Other) and ethnicity cohorts (Hispanic, Non-hispanic), we examined the proportion of each procedure performed annually compared to the others in the same category. Interventions N/A Measurements and Main Results From 2007 to 2018, 322,834 hysterectomies were collected (216,413 White, 46,248 Black, 60,173 Other; and 33,881 Hispanic). From 2007 to 2018, rates of laparoscopic hysterectomy increased in all cohorts (29% to 71% for White, 23% to 56% for Black, 16% to 60% for Other; and 20% to 64% for Hispanic; ptrend Conclusion As compared to White women, black women are less likely to undergo benign hysterectomy via a minimally invasive approach. Black women are more likely to have larger uteri and comorbid conditions which may attribute to higher rates of abdominal hysterectomy. Higher prevalence of abdominal hysterectomy among younger Black women highlights potential racial disparities in women's healthcare.