Health-related quality of life after risk-reducing hysterectomy: a randomised vignette study
In brief
One-year after hysterectomy quality of life near perfect, falls with ovary removal
In a UK vignette study of 1000 women, the average health-utility score one year after risk-reducing hysterectomy was 0.94, essentially the same as the general population, but dropped to 0.84 when the procedure also removed both ovaries. Scores were lower in the first month after surgery, and valuations varied with age, obesity and income, highlighting factors to discuss when counselling high-risk patients.
- Journal
- Gynecologic oncology (Q1)
- Published
- 8 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Samuel Oxley, Amanda Dibden, Tia Whenham, Xia Wei, Lea Mansour, Ashwin Kalra, et al.
- PMID
- 42570385
- DOI
- 10.1016/j.ygyno.2026.07.021
Why clinicians should know about it
- Picked for Obstetrics and Gynecology (top studies of the week, 9 August 2026).
Abstract
BACKGROUND: Risk-reducing hysterectomy (RRH) is the most effective endometrial cancer preventive strategy. Understanding health-related quality-of-life using health-related utility-scores (HRUS) is essential for counselling, shared decision-making, and informing health-economic evaluations of endometrial cancer prevention. This study aimed to determine HRUS for premenopausal RRH, with and without bilateral salpingo-oophorectomy (BSO). METHODS: Preventing Endometrial-Cancers: Comparing Risk-Reducing Strategies (PRESCORES) (ISRCTN17432105) part-2 is a UK-based randomised vignette study. Following a robust development process, vignettes described four postoperative health-states for a 40-year-old otherwise-healthy woman: "RRH at 1-month", "RRH at 1-year", "RRH-BSO at 1-month", "RRH-BSO at 1-year". These were valued using EQ-5D by participants recruited from the UK general-population and HRUS calculated. Utilities were subsequently adjusted by age-and sex-matched general-population reference values. Association of variables was explored with ordinary-least-squares regression with non-parametric bootstrapping. FINDINGS: Overall, 1001 women were included and randomised to 1-of-4 groups. The mean-age(±SD) was 53.6 (±11.4) years. Mean(±SD) HRUS were 0.942 (±0.072) for "RRH at 1-year", 0.841 (±0.137) for "RRH-BSO at 1-year", 0.670 (±0.149) for "RRH at 1-month", and 0.733 (±0.190) for "RRH-BSO at 1-month", with significant difference between each group (p < 0.001). Adjusting for age-sex-matched population reference utilities, HRUS were 1.000(95% CI:1.00-1.00), 0.994(95% CI:0.97-1.00), 0.866(95% CI:0.84-0.90) and 0.791(95% CI:0.77-0.81), respectively. Participant factors associated with vignette valuations included age, obesity, heavy menstrual-bleeding, higher income and mixed/other ethnicity. CONCLUSION: This randomised study provides HRUS following premenopausal RRH with and without BSO at two postoperative time-points, with adjustment against the age-and sex-matched general reference-population. These values are of relevance for informing counselling of women at increased endometrial cancer-risk regarding RRH and for health-economic evaluations.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.