Introduction
In 2016, ovarian cancer will account for approximately 5% of cancer-related deaths for women in the United States, with 85% of cases diagnosed at advanced stages. In recent years, it has been suggested that ovarian cancer results from precancerous lesions arising in the fallopian tube and transferring to the ovary. If the model is correct, removal of the fallopian tubes may effectively reduce a woman’s risk of developing ovarian cancer without the subsequent complications associated with oophorectomy, such as the sequelae of surgical menopause. As a result, in 2013, the Society of Gynecologic Oncology recommended consideration of salpingectomy at the time of any benign pelvic surgery for women at average risk of ovarian cancer. This new approach to ovarian cancer prevention could substantially increase rates of salpingectomy. This research letter measures recent trends in salpingectomy, and compares them to trends in other pelvic surgeries.
Materials and Methods
International Classification of Diseases, Ninth Revision ( ICD-9 ) codes for general pelvic surgical procedures were identified and grouped into the following procedure categories: hysterectomy ( ICD-9 codes 68.3, 68.31, 68.39, 68.4, 68.41, 68.49, 68.5, 68.51, 68.59), oophorectomy ( ICD-9 codes 65.3, 65.31, 65.39, 65.5, 65.51, 65.52, 65.53, 65.54), salpingo-oophorectomy ( ICD-9 codes 65.4, 65.41, 65.49, 65.6, 65.61, 65.62, 65.63, 65.64), bilateral tubal ligation ( ICD-9 codes 66.2, 66.21, 66.22, 66.29, 66.3, 66.31, 66.32, 66.39), and salpingectomy alone ( ICD-9 codes 66.5, 66.51, 66.52, 66.6, 66.62, 66.63, 66.69). Although a detailed assessment of surgical indication was not generally possible, pelvic surgeries for clearly nonbenign indications (eg, radical abdominal hysterectomy, radical vaginal hysterectomy, and pelvic evisceration) were not included. Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, the largest public all-payer inpatient claims database, was used to produce national estimates of the annual number of hospitalizations involving each procedure category from 2000 through 2013, the most recently available data. The research did not distinguish between primary procedures and procedures performed concomitantly with other procedures. Nationwide statistics in HCUP incorporate trend weights that allow for accurate longitudinal comparison. The percent change since 2000 was calculated for each procedure category for each year.
Materials and Methods
International Classification of Diseases, Ninth Revision ( ICD-9 ) codes for general pelvic surgical procedures were identified and grouped into the following procedure categories: hysterectomy ( ICD-9 codes 68.3, 68.31, 68.39, 68.4, 68.41, 68.49, 68.5, 68.51, 68.59), oophorectomy ( ICD-9 codes 65.3, 65.31, 65.39, 65.5, 65.51, 65.52, 65.53, 65.54), salpingo-oophorectomy ( ICD-9 codes 65.4, 65.41, 65.49, 65.6, 65.61, 65.62, 65.63, 65.64), bilateral tubal ligation ( ICD-9 codes 66.2, 66.21, 66.22, 66.29, 66.3, 66.31, 66.32, 66.39), and salpingectomy alone ( ICD-9 codes 66.5, 66.51, 66.52, 66.6, 66.62, 66.63, 66.69). Although a detailed assessment of surgical indication was not generally possible, pelvic surgeries for clearly nonbenign indications (eg, radical abdominal hysterectomy, radical vaginal hysterectomy, and pelvic evisceration) were not included. Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample, the largest public all-payer inpatient claims database, was used to produce national estimates of the annual number of hospitalizations involving each procedure category from 2000 through 2013, the most recently available data. The research did not distinguish between primary procedures and procedures performed concomitantly with other procedures. Nationwide statistics in HCUP incorporate trend weights that allow for accurate longitudinal comparison. The percent change since 2000 was calculated for each procedure category for each year.
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