Cancer of the lining of the uterus is the most frequent gynecological cancer. It is estimated there would be 40,880 new cases of endometrial cancer in the United States in 2005 (American Cancer Society, 2005b). Symptoms include abnormal uterine bleeding and/or spotting. Because a Pap smear is rarely effective in detecting early endometrial cancer, a D&C (dilation and curettage) is more reliable. Treatment options for endometrial cancer include surgery, radiation, hormones, and/or chemotherapy.
Endometrial cancer generally affects women over 50 and is a major reason for hysterectomies in that age group. If detected at an early stage, over 90% will survive at least 5 years. Use of birth control pills has been found to decrease the incidence of endometrial cancer.
Question: Is it true that the United States has a really high rate for hysterectomy? Are some being done unnecessarily?
The United States has one of the highest rates of hysterectomy in the world (Bren, 2001). In fact, today hysterectomy is the most common major gynecologic operation in the United States (Thakar et al., 2002).
It is estimated that every 10 minutes, 12 hysterectomies are performed in the United States alone. A hysterectomy may be performed for a variety of medical problems, including uterine fibroids, endometriosis, cancer, chronic pelvic pain, abnormal uterine bleeding, and pelvic infection, or if there is abnormal bleeding after a delivery of a baby. Today there are several new options—medications and various procedures—to treat uterine conditions, which has decreased the overall hysterectomy rate. Rates have also been falling because of increased patient involvement (A. Kennedy et al., 2002).