Rates of Opportunistic Salpingectomy During Minimally-Invasive Benign Hysterectomy By Race/Ethnicity from 2016 to 2021

Abstract

Study Objective

The Society of Gynecologic Oncology recommends opportunistic salpingectomy during benign hysterectomy to reduce the risk of epithelial ovarian cancers. A previous study indicated racial discrepancies in the adoption rates of risk-reducing salpingectomies at time of hysterectomy from 2011-2018. We performed an updated analysis to determine if these differences persist.

Design

Retrospective cohort study.

Setting

Over 700 academic and community hospitals in the American College of Surgeons National Surgical Quality Improvement Program.

Patients or Participants

Patients 18-50 years old undergoing minimally invasive benign hysterectomy from 2016-2021.

Interventions

Billing codes were used to identify patients who underwent total laparoscopic hysterectomy (TLH), total vaginal hysterectomy (TVH), or laparoscopic-assisted vaginal hysterectomy (LAVH), with or without bilateral salpingectomy. Patients were identified in the dataset as Non-Hispanic White (NHW), Non-Hispanic Black (NHB), or Hispanic. Log-binomial regression was used to calculate risk ratio (RR) and 95% confidence intervals (CI) of salpingectomy for NHB, and Hispanic patients compared to NHW patients.

Measurements and Main Results

Of 117,587 patients, 65% were NHW, 17.1% NHB, and 17.8% Hispanic. Of these patients, 70.6% underwent TLH, 12.8% TVH, and 16.6% LAVH. 86.9% of all patients underwent salpingectomy. When compared to NHW patients undergoing TLH, NHB and Hispanic patients were as likely to undergo salpingectomy [NHB RR 0.98 (CI 0.97-0.98); Hispanic RR 0.99 (CI 0.99-0.999)]. The same was true for patients undergoing TVH [NHB RR 1.04 (CI 0.997-1.1); Hispanic RR 1.1 (CI 1.1-1.2)] and LAVH [NHB RR 0.95 (CI 0.93-0.97); Hispanic 0.997 (CI 0.98-1.01)]. RRs remained similar after adjusting for age, diabetes, smoking, hypertension, American Society of Anesthesiologists class, and year of operation.

Conclusion

These findings suggest minimal differences in salpingectomy rates among racial and ethnic groups between 2016-2021. This is a change from prior studies and may indicate national improvements in reducing health disparities associated with opportunistic salpingectomy.