Scholarlink

Objective <p>Endometriosis often presents in adolescence as chronic pelvic pain (CPP) or dysmenorrhea. Research in adults demonstrates non-White race is associated with delayed surgical diagnosis of endometriosis; however, inequity in adolescents has never been studied. We investigated inequities in laparoscopy rates among adolescents according to race, ethnicity, and socioeconomic status (SES).</p> Methods <p>We performed a retrospective cohort study of outpatient and operating room visits at a single academic medical center in the midwestern United States. Subjects were aged 10–21 who were seen by a gynecologic subspecialist between 2013 and 2023 for dysmenorrhea or CPP. Subjects with a previous diagnosis of endometriosis by prior laparoscopy or found to have an adnexal mass or cyst at the time of laparoscopy were excluded. Subjects were classified as non-surgical, undergoing scheduled laparoscopy, or undergoing emergent laparoscopy. Analyses used race, ethnicity, and SES data abstracted from the electronic health record.</p> Results <p>Of 4,480 eligible subjects, 4,426 were expectantly managed, 47 underwent scheduled laparoscopy, and seven underwent emergent laparoscopy. Compared to White subjects, Black subjects were significantly less likely to receive any laparoscopy (OR 0.20, 95% CI 0.03–0.69, <i>p</i> = .010) or non-emergent surgery (OR 0.01, 95% CI 0.00-0.20, <i>p</i> &lt; .001), and Asian subjects were less likely to undergo any laparoscopy (OR &lt; 0.01, 95% CI 0.00-0.39, <i>p</i> = .009). Hispanic subjects were marginally less likely to undergo scheduled laparoscopy (OR 0.19, 95% CI 0.01–1.16, <i>p</i> = .082) than non-Hispanic subjects.</p> Conclusion <p>This study identified inequities in rates of laparoscopy among adolescents, with surgery performed at lower rates for Black, Asian, and Hispanic subjects.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Racial and Ethnic Inequities in Rates of Diagnostic Laparoscopy for Evaluation of Endometriosis in Adolescents with Pelvic Pain: a Retrospective Cohort Study

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年12月1日

查看全文
  • Lauren Capra,
  • Kathleen E. O’Brien,
  • Susan J. Woolford,
  • Niko A. Kaciroti,
  • Harlan McCaffery,
  • Cheyney C. Dobson,
  • Erin Isaacson,
  • Monica W. Rosen

摘要

Objective

Endometriosis often presents in adolescence as chronic pelvic pain (CPP) or dysmenorrhea. Research in adults demonstrates non-White race is associated with delayed surgical diagnosis of endometriosis; however, inequity in adolescents has never been studied. We investigated inequities in laparoscopy rates among adolescents according to race, ethnicity, and socioeconomic status (SES).

Methods

We performed a retrospective cohort study of outpatient and operating room visits at a single academic medical center in the midwestern United States. Subjects were aged 10–21 who were seen by a gynecologic subspecialist between 2013 and 2023 for dysmenorrhea or CPP. Subjects with a previous diagnosis of endometriosis by prior laparoscopy or found to have an adnexal mass or cyst at the time of laparoscopy were excluded. Subjects were classified as non-surgical, undergoing scheduled laparoscopy, or undergoing emergent laparoscopy. Analyses used race, ethnicity, and SES data abstracted from the electronic health record.

Results

Of 4,480 eligible subjects, 4,426 were expectantly managed, 47 underwent scheduled laparoscopy, and seven underwent emergent laparoscopy. Compared to White subjects, Black subjects were significantly less likely to receive any laparoscopy (OR 0.20, 95% CI 0.03–0.69, p = .010) or non-emergent surgery (OR 0.01, 95% CI 0.00-0.20, p < .001), and Asian subjects were less likely to undergo any laparoscopy (OR < 0.01, 95% CI 0.00-0.39, p = .009). Hispanic subjects were marginally less likely to undergo scheduled laparoscopy (OR 0.19, 95% CI 0.01–1.16, p = .082) than non-Hispanic subjects.

Conclusion

This study identified inequities in rates of laparoscopy among adolescents, with surgery performed at lower rates for Black, Asian, and Hispanic subjects.