Racial and Socioeconomic Factors Associated with Hysterectomy for Uterine Fibroids

Area of Science:

• Reproductive Health
• Health Disparities
• Socioeconomic Determinants of Health

Background:

• Uterine fibroids affect millions of individuals, with treatment decisions often influenced by various factors.
• Understanding disparities in treatment is crucial for equitable healthcare.
• Hysterectomy and uterine-preserving surgeries are common treatment options.

Purpose of the Study:

• To investigate the association between race, social determinants of health (SDOH), and the choice between hysterectomy and uterine-preserving fibroid treatment.
• To identify potential disparities in fibroid treatment based on patient characteristics.

Main Methods:

• Retrospective cohort study utilizing deidentified claims and longitudinal health data.
• Inclusion of patients aged 15-55 with newly diagnosed fibroids (2010-2023).
• Logistic regression analysis to assess associations between SDOH and hysterectomy receipt.

Main Results:

• Over 73,000 individuals were analyzed; 50,645 underwent hysterectomy and 22,834 received uterine-preserving treatment.
• Lower income, lower education, and rurality were associated with higher odds of hysterectomy.
• People of color had lower odds of hysterectomy compared to White individuals, even after adjusting for covariates.

Conclusions:

• Socioeconomic disadvantages (income, education, rurality) are linked to a higher likelihood of hysterectomy for fibroid treatment.
• Racial disparities exist, with people of color less likely to undergo hysterectomy compared to uterine-preserving options.
• Addressing SDOH is essential for equitable fibroid treatment access and outcomes.