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Variation of Clinical Judgment in Cases of Hysterectomy in R.O.C., Japan, England, and the United States

Working Paper

Published By

Shorenstein APARC, page(s): 14

October 1998

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Hysterectomy is the most common non-pregnancy-related major surgery performed on women in the United States. Close to 600,000 women in the United States undergo the procedure each year, with annual costs exceeding $5 billion. By age 60, more than one-third of women in the United States have had a hysterectomy.

Many believe that the high U.S. hysterectomy rate is a result of an expansion of the accepted indications for hysterectomy. More reasons are listed for removal of the uterus than for any other organ, with indications ranging from life-threatening cancer of the genital tract to menstrual pain. In the United States, hysterectomy is widely accepted by medical professionals and by the public as an appropriate treatment for uterine cancer and for various common non-cancerous uterine conditions that produce disabling levels of pain, discomfort, uterine bleeding, emotional distress, and related symptoms.

With so many possible indications for hysterectomy, the decision as to when to perform the procedure may be a great contributing factor in the different rates of hysterectomy between countries. This study poses the question, "Does individual physician decision-making affect hysterectomy rates in different countries?"

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