National Study Indicates Underutilization of Uterine Fibroid Embolization
March 6, 2017—The Society of Interventional Radiology (SIR) announced that a large nationwide study examining the treatment of uterine fibroids showed that minimally invasive, image-guided uterine fibroid embolization (UFE) is vastly underutilized compared to hysterectomies, especially in rural and smaller hospitals. The study was presented at SIR's 2017 annual scientific meeting, held March 4–9 in Washington, DC.
Among the findings, there were more than 65 times as many hysterectomies performed than UFEs, despite data showing that UFE results in substantially lower costs and shorter hospital stays than hysterectomy.
In SIR's announcement, the study's Lead Investigator, Prasoon Mohan, MD, commented, “These findings suggest there is a lack of awareness about this safe, effective, and less invasive therapy for uterine fibroids. Interventional radiologists urge health care professionals to present patients with all available treatment options so that the patient can make an informed decision. Patients need to know about the major differences between surgical treatments and UFE, especially that this is a nonsurgical treatment that preserves the uterus and has a much faster recovery time compared to hysterectomy.” Dr. Mohan is Assistant Professor in the Department of Interventional Radiology at the University of Miami Leonard M. Miller School of Medicine in Miami, Florida.
According to SIR announcement, this study included an analysis of data from the 2012 and 2013 Nationwide Inpatient Sample (NIS), the largest all-payer inpatient health care database in the country. Using billing codes that identified hysterectomies and UFEs completed for the treatment of uterine fibroids, investigators compared how women were treated for this condition, the costs of the treatments, and the outcomes.
The NIS data revealed that over this period, 165,000 more hysterectomies were performed than UFEs (167,650 vs 2,470) nationwide. Furthermore, 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 hospitals systems.
Dr. Mohan 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.”
The data also showed that UFE resulted in shorter hospital stays compared with hysterectomy (2.16 vs 2.32 days) and was less expensive than hysterectomy by approximately $12,000 ($21,583 vs $33,104). The women who elected to undergo UFE had more chronic conditions than found in the patients who underwent a hysterectomy.
UFE results in the fibroid softening, bleeding less, and shrinking in size. Approximately nine out of 10 patients who undergo UFE will experience significant improvement or their symptoms will go away completely, advised SIR.
Study abstract number 106, "Nationwide Analysis of Hospital Characteristics, Demographics, and Cost of Uterine Fibroid Embolization" by Srinivasan Narayanan, PhD, et al can be found online at www.sirmeeting.org.