Influence of education on risk of hysterectomy before age 45 years.

In a population of 4,278 women aged 36-44 years identified from Massachusetts Town Books between 1995 and 1997, relative to more highly educated women, those who completed only their high school education were about four times more likely (95% confidence interval: 1.8, 10.8) to have undergone hysterectomy, regardless of smoking status, body mass index, or medical indications for the hysterectomy. Possible explanations are that less educated women may delay seeking health services for gynecologic problems resulting in hysterectomy as the last treatment option or may be offered hysterectomy as the primary treatment option by their physicians. Future studies should assess diagnoses that lead to hysterectomy and the interval between onset of the condition and delivery of medical care.