{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:33:35Z","timestamp":1777577615589,"version":"3.51.4"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,5,4]],"date-time":"2021-05-04T00:00:00Z","timestamp":1620086400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Hysterectomy has been one of the most common surgical procedures in women in Finland. We studied the population\u2010based trends of hysterectomy and its indications from 1986 to 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>A retrospective population\u2010based cohort was created from the Care Register for Health Care by identifying women who had a hysterectomy from 1986 to 2017 and calculating the number of women from the Digital and Population Data Services Agency. We estimated the number and incidence of hysterectomy by period and age as well as by indication. We considered the primary diagnosis at the time of surgery as the indication of hysterectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The number of hysterectomies increased from 7492 procedures in 1986 to 12\u00a0404 procedures in 1998, and reduced substantially after that to 5971 procedures in 2017, the turning point being in 1999. The incidence rate of hysterectomy has decreased on average by 2.5% annually from 432.6 per 100\u00a0000 women in 1998\u20132001 to 224.5 per 100\u00a0000 women in 2014\u20132017. The median age at the time of hysterectomy has increased from 51\u00a0years in 1998\u20132001 to 55\u00a0years in 2014\u20132017. The cumulative burden of hysterectomy by age of 60\u00a0years has nearly halved from the first 4\u2010year period (23%) to the last (12%). After 2010, the most common indication has been genital prolapse and incontinence, whereas earlier it was uterine fibroids.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The number and incidence of hysterectomies have fluctuated during the observation period 1986\u20132017 and decreased considerably during the past 17\u00a0years in Finland. This is probably a result of the availability of hormonal and other conservative treatment options for bleeding disorders and uterine fibroids. As hysterectomy practically removes the risk for endometrial cancer, the change in hysterectomy incidence over time emphasizes the importance of correcting endometrial cancer incidence according to hysterectomy incidence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14159","type":"journal-article","created":{"date-parts":[[2021,4,2]],"date-time":"2021-04-02T07:14:47Z","timestamp":1617347687000},"page":"1722-1729","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Decreasing trend and changing indications of hysterectomy in Finland"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0792-3532","authenticated-orcid":false,"given":"Jenni","family":"Hakkarainen","sequence":"first","affiliation":[{"name":"Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research Helsinki Finland"},{"name":"Faculty of Medicine and Health Technology (MET) Tampere University Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Central Finland Central Hospital Jyv\u00e4skyl\u00e4 Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9253-4493","authenticated-orcid":false,"given":"Aapeli","family":"Nevala","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eija","family":"Tom\u00e1s","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology (MET) Tampere University Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"},{"name":"Tays Cancer center Tampere University Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4498-9300","authenticated-orcid":false,"given":"Kari","family":"Nieminen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine and Health Technology (MET) Tampere University Tampere Finland"},{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"},{"name":"Tays Cancer center Tampere University Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8127-8087","authenticated-orcid":false,"given":"Nea","family":"Malila","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9879-6673","authenticated-orcid":false,"given":"Janne","family":"Pitk\u00e4niemi","sequence":"additional","affiliation":[{"name":"Finnish Cancer Registry Institute for Statistical and Epidemiological Cancer Research Helsinki Finland"},{"name":"Department of Public Health School of Medicine University of Helsinki Helsinki Finland"},{"name":"Faculty of Social Sciences Tampere University Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9678-4684","authenticated-orcid":false,"given":"Annika","family":"Auranen","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Tampere University Hospital Tampere Finland"},{"name":"Tays Cancer center Tampere University Hospital Tampere Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,5,4]]},"reference":[{"key":"e_1_2_9_2_1","unstructured":"Nordic Medico\u2010Statistical Committee.Health Statistics for the Nordic Countries 1995\u20132017. 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