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US hysterectomy prevalence by age, race and ethnicity from BRFSS and NHIS: implications for analyses of cervical and uterine cancer rates

Abstract

Purpose

Previous reports of gynecologic cancer rates have adjusted for hysterectomy prevalence with data from the Behavioral Risk Factor Surveillance System (BRFSS) or the National Health Interview Survey (NHIS). We sought to determine if BRFSS and NHIS produce similar estimates of hysterectomy prevalence.

Methods

Using data from BRFSS and NHIS, we calculated hysterectomy prevalence for women aged 20–79 years, stratified by 10-year age groups, survey year (2010, 2018), and race/ethnicity (Hispanic, non-Hispanic American Indian or Alaskan Native, non-Hispanic Asian, non-Hispanic Black, non-Hispanic White, non-Hispanic all other race groups).

Results

BRFSS and NHIS produced similar increasing trends in hysterectomy prevalence by age and directional differences by race and ethnicity. Fewer than 2% of women aged 20–29 years and more than 4 out of 10 women aged 70–79 years reported having had a hysterectomy.

Conclusion

Our analyses suggest adjustment for hysterectomy prevalence with data from either survey would likely reduce distortion in cervical and uterine cancer rates. BRFSS, a survey which has a larger sample size than NHIS, may better support analyses of hysterectomy estimates for smaller subpopulations.

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Acknowledgments

This paper benefited from a statistical consult from our colleague Simone Gray, PhD.

Funding

This research was supported in part by an appointment (EE Adam) to the Research Participation Program at CDC administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC. The other authors are federal employees and their work on this paper was performed as part of their official duties. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Correspondence to Emily E. Adam.

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Adam, E.E., White, M.C. & Saraiya, M. US hysterectomy prevalence by age, race and ethnicity from BRFSS and NHIS: implications for analyses of cervical and uterine cancer rates. Cancer Causes Control (2021). https://doi.org/10.1007/s10552-021-01496-0

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Keywords

  • Behavioral Risk Factor Surveillance System
  • Cervical cancer
  • Hysterectomy
  • National Health Interview Survey
  • Uterine cancer
  • Women’s health