Department of Obstetrics and Gynaecology, Christchurch School of Medicine,
Christchurch, New Zealand.

The figure shows rates for hysterectomy performed in women for each year of age from 25 to 85 years in a country with a health service offering both public and private surgical options. It is typical of many countries with relatively high per capita income and easy access to hospital services. There is concern that 'discretionary' surgical procedures for relatively minor indications may not always be the best healthcare option.

1. What is the cumulative probability that a woman living in the country from which the data are derived will have a hysterectomy? (note: average female life expectancy is 85 years)?
   
   
2. In which decade of life are these women most likely to have a hysterectomy?
   
   
   Answer questions 3, 4, and 5 based on your clinical knowledge:
   
   
3. What is the most likely diagnosis leading to hysterectomy being performed in a woman before menopause?
   
   
4. What long-term risks are associated with hysterectomy when it is performed before menopause?
   
   
5. What health service, social and cultural factors may contribute to high hysterectomy rates?
   
   

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