ACS 2018: Surgical Sterilization Among Men and Women in the U.S. with Employer-Based Insurance

Boston, Massachusetts ( Amir I. Khan aimed to assess the sociodemographic variability in the use of surgical sterilization. They queried the MarketScan Commercial Claims database using CPT, ICD9, and HCPCS codes to identify 658,509 individuals who underwent male or female sterilization between 2009-2014 and examined differences in age, geographic distribution, and family size.

Between 2009-2014, 422,290 men and 236,219 women with employer-sponsored insurance underwent vasectomy and tubal sterilization, respectively. The annual number of vasectomies decreased from 77,565 in 2009 to 61,436 in 2014 (p<0.001), while the annual number of tubal sterilizations decreased from 43,766 to 30,465 (p<0.001) over the same time period. Median age at time of male or female sterilization was 38 and 37 years, respectively. The decision to undergo sterilization at age 35 or older was associated with a family size of 4 or more individuals (p<0.001). Sterilization was more common in metropolitan statistical areas (MSAs), with 84% of vasectomies and 79% of tubal sterilizations performed in MSAs. 79% of men compared to 60% of women who underwent sterilization were the primary insurance policyholders (p<0.001).

In summary, vasectomy was twice as common as tubal sterilization in this cohort. Use of surgical sterilization was associated with increased age and larger family size. There was a decline in the annual number of both male and female sterilizations during the study period. The authors were encouraged to understand variation according to change in politics (i.e. Republican vs. Democrat Presidency).

Presented by: Amir I. Khan, Emory University, Atlanta, GA

Written by: Stephen B. Williams, MD., Associate Professor, Division of Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish M. Kamat, MD. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX at the 2018 American College of Surgeons Clinical Congress, October 21-25, 2018 in Boston, Massachusetts