Uterine Fibroid Embolization 'Vastly' Underused

By Megan Brooks

March 07, 2017

NEW YORK (Reuters Health) - Uterine fibroid embolization (UFE) is vastly underused, especially in rural and smaller hospitals, according to research presented March 6 at the Society of Interventional Radiology annual meeting.

“These findings suggest there is a lack of awareness about this safe, effective and less invasive therapy for uterine fibroids,” said Dr. Prasoon Mohan, the study’s lead author and assistant professor in the department of interventional radiology at the University of Miami Leonard M. Miller School of Medicine, in a conference statement.

“The majority of women, almost three out of four, will develop uterine fibroids by the age of 50,” Dr. Mohan noted during a media briefing. In addition to older age, risk factors for uterine fibroids include being overweight, African-American race, having hypertension, having had no children, and having a first-degree relative with fibroids, he said.

“When it comes to treatment, women have a variety of options, ranging from hysterectomy to uterine fibroid embolization,” Dr. Mohan said.

Based on data from the Nationwide Inpatient Sample (NIS), UFE remains far less common than hysterectomy, despite being minimally invasive and costing less.

Between 2012 and 2013, 165,000 more hysterectomies were performed than UFEs (167,650 vs. 2,470) nationwide, Dr. Mohan reported.

Only 0.4% of UFEs were performed in rural hospitals compared to 9.4% of hysterectomies in the same setting; and 7.9% of UFEs were performed in small hospital systems compared to 67.4% in large hospital systems, he noted.

“The fact that so few women undergo UFE in rural and small hospital settings shows a health care access and education disparity in who receives this treatment. It is important that we continue to educate patients about choice and determine ways to increase access to this effective, less invasive therapy,” Dr. Mohan said.

Women who underwent UFE spent less time in the hospital (2.16 days for UFE vs. 2.32 days for hysterectomy) and had about $12,000 lower total hospital charges than women who underwent hysterectomy ($21,583 vs. $33,104), he reported.

“Several large randomized controlled trials have shown that UFE is safe and effective for treatment of fibroids. But still, more than two decades after its introduction, UFE is vastly underutilized, despite being cheaper and better tolerated compared to hysterectomy,” Dr. Mohan said.

“This is especially important in today's healthcare environment where there is a lot of focus on delivering value-based care. There seems to be lack of awareness especially in rural and smaller hospital settings about uterine fibroid embolization.”

SOURCE: http://bit.ly/2meCdND

Society of Interventional Radiology 2017.