Analysis of the Relationship between Socioeconomic Status and Incidence of Hysterectomy Using Data of the Korean Genome and Epidemiology Study (KoGES)

Abstract

Hysterectomy remains a frequent gynecologic surgery, although its rates have been decreasing. The aim of this study was to investigate whether socioeconomic status affected the risk of hysterectomy in Korean women. This prospective cohort study used epidemiologic data from 2001 to 2016, from the Korean Genomic and Epidemiology Study (KoGES). Multivariate logistic regression analyses were performed to estimate the association between household income or education level and hysterectomy. Among 5272 Korean women aged 40–69 years, 720 who had a hysterectomy and 4552 controls were selected. Variable factors were adjusted using logistic regression analysis (adjusted model). Adjusted odds ratios (aORs) for insurance type and hysterectomy were not statistically significant. The aOR was 1.479 (95% confidence interval (CI): 1.018–2.146, p < 0.05) for women with education of high school or lower compared to college or higher. Women whose monthly household income was < KRW 4,000,000 had a higher risk of undergoing hysterectomy than women whose monthly household income was ≥ KRW 4,000,000 (aOR: 2.193, 95% CI: 1.639–2.933, p < 0.001). Overall, the present study elucidated that lower socioeconomic status could increase the incidence of hysterectomy. Our results indicate that the implementation of stratified preventive strategies for uterine disease in those with low education and low income could be beneficial.

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“…Another study conducted in Korea similarly concluded that patients with lower income were more likely to undergo a hysterectomy because of the delay in seeking medical treatment, because conservative approaches are more readily available to individuals with higher income, and because of the perception among individuals with lower income that hysterectomy is a cheaper and safer option. 32 This is in the context of new, uterus-sparing alternatives. Nevertheless, given the limited data and incidence of hysterectomy in our study, these findings are unreliable.…”