Racial disparities in non-hysterectomy surgeries for endometriosis

Tarangi Sutaria , Katherine Freedy , Lisa Flowers , Marie Shockley , Danielle M. Blemur , Whitney A. Barnes , Mark Lachiewicz
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Abstract

Objective

To evaluate the self-reported prevalence of hysterectomy and non-hysterectomy surgeries for endometriosis by race/ethnicity.

Methods

This cross-sectional study used data from the National Survey of Family Growth (NSFG) 2017–2019 cycle. This study included persons ages 15–49 years who identify as female and who reported receiving a diagnosis of endometriosis from a healthcare professional. The main study outcomes were self-reported receipt of hysterectomy and non-hysterectomy surgeries for endometriosis. The main exposure was race/ethnicity. Multivariable logistic regression estimated adjusted prevalence odds ratios and 95% confidence intervals of hysterectomy and non-hysterectomy endometriosis surgery. Differences in social determinants of health (SDH) among women who did and did not receive non-hysterectomy endometriosis surgery were tested using chi-square analysis.

Results

Of 6,141 survey participants, 314 (5.11%) answered yes to ever being diagnosed with endometriosis. While there were no significant differences in the odds of having a hysterectomy for endometriosis when stratifying by race/ethnicity, Black women had a significantly lower odds of non-hysterectomy endometriosis surgery compared to White women. The analysis of SDH revealed a higher prevalence of poverty among women who did not receive non-hysterectomy endometriosis surgeries. However, including poverty in the multivariable logistic regression model did not alter racial disparity findings.

Conclusion

White women have over four times higher odds of receiving non-hysterectomy endometriosis surgery compared to Black women in a fully adjusted model, which cannot be explained by a secondary analysis of SDH. Further examination of factors that may influence decisions on surgery for endometriosis will create a better understanding of disparities in endometriosis care.
子宫内膜异位症非子宫切除手术的种族差异
目的评价不同种族/民族的子宫内膜异位症患者自我报告的子宫切除术和非子宫切除术的患病率。方法:本横断面研究使用了2017-2019年全国家庭增长调查(NSFG)周期的数据。这项研究包括年龄在15-49岁的女性,并报告从医疗保健专业人员那里接受了子宫内膜异位症的诊断。主要研究结果为子宫内膜异位症患者接受子宫切除术和非子宫切除术的自我报告。主要的暴露是种族/民族。多变量logistic回归估计子宫切除术和非子宫切除术子宫内膜异位症手术的校正患病率优势比和95%置信区间。在接受和未接受非子宫切除术子宫内膜异位症手术的妇女中,健康的社会决定因素(SDH)的差异使用卡方分析进行检验。结果6141名调查参与者中,314名(5.11%)回答曾被诊断为子宫内膜异位症。虽然按种族/民族分层,因子宫内膜异位症而进行子宫切除术的几率没有显著差异,但与白人女性相比,黑人女性进行非子宫切除术子宫内膜异位症手术的几率明显较低。SDH分析显示,未接受非子宫切除术子宫内膜异位症手术的妇女贫困发生率较高。然而,在多变量逻辑回归模型中包括贫困并没有改变种族差异的发现。结论在完全调整后的模型中,白人女性接受非子宫切除术子宫内膜异位症手术的几率比黑人女性高4倍以上,这不能通过SDH的二次分析来解释。进一步检查可能影响子宫内膜异位症手术决定的因素将更好地了解子宫内膜异位症护理的差异。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of endometriosis and uterine disorders
Journal of endometriosis and uterine disorders Obstetrics, Gynecology and Women's Health
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