[Early diagnosis of cancer in operative gynaecology. II. On the general effects of preventive cancer examinations on operative gynaecology (author's transl].

Beyond early diagnosis of cancer and treatment of cancer the increase of gynaecological operation is primarily due to a liberalization of the indications. That more women have gynaecologic disease in the framework of the classical indications than before cannot be substantiated. The causes of the changes in indications are outlined. Demands of patients as consumers on a new expansive medical care system are among the changes. Self interests of the Obstetricians and Gynaecologists who constitute a larger percentage of medical specialists at present are part of the reason. The principle of preventive examinations has a psychological impact and the practice of the preventive examinations has an administrative impact on the increasing number of gynaecological operations. This trend is discussed with the example of hysterectomy. The experience of other countries is mentioned in which the advantages and disadvantages of an increasing number of gynaecological operations is analyzed and in which a regulation is attempted to prevented escalating costs. It can be assumed that a similar analysis and regulation will become necessary in Germany.