Vital Signs Blog

Researchers affirm cancer risk of common uterine procedure

About 1 of every 370 women who underwent a minimally invasive hysterectomy using morcellation was found to have uterine cancer, a finding that is consistent with data that the Food and Drug Administration put out this month.

The use of morcellation in those cases can lead to the spread of undetected cancer, which has become a widespread concern this year among patients, regulators and physicians.

The procedure involves a medical device—a power morcellator—that breaks up uterine tissue into smaller pieces so it can be removed from the body. It's often used in minimally invasive hysterectomies for women who would otherwise have to undergo open surgery.

A study published Tuesday by JAMA found that uterine cancer occurred in 27 out of every 10,000 women who underwent a minimally invasive hysterectomy using morcellation. The findings come from an insurance database that includes data from 500 hospitals capturing 15% of total hospitalizations in the U.S.

“Despite the commercial availability of electric power morcellators for two decades, accurate estimates of the prevalence of malignancy at the time of electric power morcellation are lacking,” the authors wrote.

The FDA released a report in July that found 1 in 350 women who underwent a hysterectomy or fibroid removal surgery also had uterine sarcoma.

Previous estimates put the prevalence of malignances closer to nine or 10 women among every 10,000. This study found about 15% of women who underwent a minimally invasive hysterectomy had morcellation performed during procedures that occurred between 2006 and 2012.

Fresh concern about how many women were at risk for uterine cancer before undergoing a hysterectomy led researchers to conduct the study. “The findings are higher than we thought,” said Dr. Jason Wright, one of the authors and the chief of gynecologic oncology at New York Presbyterian Hospital.

An FDA advisory committee is evaluating whether to take new action that could prevent or limit the use of morcellation in women who are at risk for the spread of cancer after issuing a warning in April against the use of morcellation for hysterectomies or the removal of uterine fibroids because of the risks of spreading cancer.

This could mean that more women undergo open surgeries in the future, Wright said.

Follow Jaimy Lee on Twitter: @MHjlee


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