Papers

Socioeconomic variation in admission for diseases of female genital system and breast in a national cohort aged 15-43

Medical Research Council National Survey of Health and Development, University College London Medical School, Department of Epidemiology and Public Health, London WC1E 6BT D J L Kuh, research scientist S L Stirling, research scientist. Correspondence to: Dr Kuh.

Abstract

Objective: To investigate socioeconomic variation among young women in the risk of hospital admission for diseases (including neoplasms) of the female genital system and breast and for the common surgical procedures of dilatation and curettage and hysterectomy.
Design: Large nationally representative cohort study with individual records of confirmed admissions to NHS and private hospitals since birth and data on occupational and educational experience.
Setting: England, Scotland, and Wales.
Patients: General population sample of 1628 women, 1549 of whom had a complete admissions record for the ages of 15-43 years.
Main outcome measures: The percentage of women admitted for neoplasms or other diseases of the female genital system and breast or who had dilatation and curettage or hysterectomy beween the ages of 15 and 43 years.
Results: By the age of 43, 35% of women had been admitted, 17% had undergone dilatation and curettage at least once, and 10% had had a hysterectomy. There were significant inverse educational gradients, the risk of admission increasing more than twofold between the most and least educated women. The differential risk was most striking for disorders of menstruation, in which only 1% of those with the highest educational qualifications and 19% of those with minimal qualifications had been admitted to hospital. There was a significant educational gradient in the hysterectomy rate (from 1% to 15%) and a twofold difference in the risk of dilatation and curettage. There were also significant gradients in risk of admission and of hysterectomy according to partner's social class.
Conclusions: Socioeconomic variations in the risk of dilatation and curettage and of hysterectomy were large. Lessening the socioeconomic gradient in risks of admissions and surgery for diseases of the female genital system and breast, particularly for menstrual disorders, could have important resource implications.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Significant social class gradient in menstrual disorders

Julie Lake, Chris Power, and Tim Cole
BMJ 1995 311: 1503. [Extract] [Full Text]

This article has been cited by other articles:

• Clarke, A., Chang, Y. M., McPherson, K. (2006). Removing organs "just in case"--is prophylactic removal of the ovaries a good thing?. J. Epidemiol. Community Health 60: 186-187 [Full text]  
• Robertson, E, Malmstrom, M, Sundquist, J, Johansson, S-E (2003). Impact of country of birth on hospital admission for women of childbearing age in Sweden: a five year follow up study. J. Epidemiol. Community Health 57: 877-882 [Abstract] [Full text]  
• Baker, D. W., Gazmararian, J. A., Williams, M. V., Scott, T., Parker, R. M., Green, D., Ren, J., Peel, J. (2002). Functional Health Literacy and the Risk of Hospital Admission Among Medicare Managed Care Enrollees. Am. J. Public Health 92: 1278-1283 [Abstract] [Full text]  
• Materia, E, Rossi, L, Spadea, T, Cacciani, L, Baglio, G, Cesaroni, G, Arca, M, Perucci, C A (2002). Hysterectomy and socioeconomic position in Rome, Italy. J. Epidemiol. Community Health 56: 461-465 [Abstract] [Full text]  
• Marshall, S. F, Hardy, R. J, Kuh, D. (2000). Socioeconomic variation in hysterectomy up to age 52: national, population based, prospective cohort study. BMJ 320: 1579-1579 [Full text]  
• Lilford, R J (1997). Hysterectomy: will it pay the bills in 2007?. BMJ 314: 160-160 [Full text]  
• Richmond, C. (1996). Results will depend on whether hysterectomy was essential or not. BMJ 313: 231c-232 [Full text]  
• Lake, J., Power, C., Cole, T. (1995). Significant social class gradient in menstrual disorders. BMJ 311: 1503a-1503 [Full text]