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Impact of hysterectomy on uterine cancer incidence rates in Egypt

Obstetrics & Gynecology International Journal
Saad Alshahrani MD PhD,1 Robert M Chamberlain, PhD,2,3 Ahmed Hablas MD,4 Steven Remmenga MD,5 Jane L Meza,6 Ibrahim A Seifeldin MD,4 Mohamed Ramadan MD,4 Mariah Murray MPH,7 Amr S Soliman MD PhD3

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Background: Uterine cancer is one of the common women’s cancers worldwide. There are significant variations in uterine cancer incidence rates globally and the incidence in Egypt is one of the lowest. Several studies have shown that hysterectomy might be a factor in underestimating the observed incidence of uterine cancer. However, no studies have been conducted in Egypt to examine this observation.
Methods: Pathologic reports of all 1040 hysterectomy specimens examined in 2013 and 2014 in the Gharbiah province, Egypt were abstracted. Prevalence of hysterectomy was estimated and used for adjusting the incidence rate of uterine cancer in the Gharbiah population-based registry by excluding the hysterectomized women from the population at risk. Pre- and post- adjustment rates were compared and 95% confidence intervals (CIs) were calculated.
Results: The prevalence of hysterectomy was estimated as 13.1 per 10,000 women, 95% CI (12.65-13.66). The prevalence of hysterectomy did not have a significant impact on uterine cancer incidence [pre-adjustment (2.78, 95% CI 2.58-3.00) and post-adjustment (2.79, 95% CI 2.58-3.00)]. Observing a significant effect of hysterectomy on underestimating the incidence of uterine cancer in this population required multiplying the observed prevalence by at least 110 times.
Discussion: This study confirmed the previously documented low incidence of uterine cancer in this population of Egypt. The lack of evidence about the possible role of hysterectomy in lowering uterine cancer incidence justifies the need for additional research to identify the protective factors for uterine cancer in this population.


Uterine cancer, Hysterectomy prevalence, Epidemiology, Egypt, Developing countries