scholarly journals The Association Between Hysterectomy and Ovarian Cancer Risk: A Population-Based Record-Linkage Study

2019 ◽  
Vol 111 (10) ◽  
pp. 1097-1103
Author(s):  
Suzanne C Dixon-Suen ◽  
Penelope M Webb ◽  
Louise F Wilson ◽  
Karen Tuesley ◽  
Louise M Stewart ◽  
...  

Abstract Background Recent studies have called into question the long-held belief that hysterectomy without oophorectomy protects against ovarian cancer. This population-based longitudinal record-linkage study aimed to explore this relationship, overall and by age at hysterectomy, time period, surgery type, and indication for hysterectomy. Methods We followed the female adult Western Australian population (837 942 women) across a 27-year period using linked electoral, hospital, births, deaths, and cancer records. Surgery dates were determined from hospital records, and ovarian cancer diagnoses (n = 1640) were ascertained from cancer registry records. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for the association between hysterectomy and ovarian cancer incidence. Results Hysterectomy without oophorectomy (n = 78 594) was not associated with risk of invasive ovarian cancer overall (HR = 0.98, 95% CI = 0.85 to 1.11) or with the most common serous subtype (HR = 1.05, 95% CI = 0.89 to 1.23). Estimates did not vary statistically significantly by age at procedure, time period, or surgical approach. However, among women with endometriosis (5.8%) or with fibroids (5.7%), hysterectomy was associated with substantially decreased ovarian cancer risk overall (HR = 0.17, 95% CI = 0.12 to 0.24, and HR = 0.27, 95% CI = 0.20 to 0.36, respectively) and across all subtypes. Conclusions Our results suggest that for most women, having a hysterectomy with ovarian conservation is not likely to substantially alter their risk of developing ovarian cancer. However, our results, if confirmed, suggest that ovarian cancer risk reduction could be considered as a possible benefit of hysterectomy when making decisions about surgical management of endometriosis or fibroids.

2016 ◽  
Vol 140 (2) ◽  
pp. 277-284 ◽  
Author(s):  
Linda S. Cook ◽  
Andy C.Y. Leung ◽  
Kenneth Swenerton ◽  
Richard P. Gallagher ◽  
Anthony Magliocco ◽  
...  

2006 ◽  
Vol 119 (10) ◽  
pp. 2423-2427 ◽  
Author(s):  
Neeraja B. Peterson ◽  
Amy Trentham-Dietz ◽  
Polly A. Newcomb ◽  
Zhi Chen ◽  
John M. Hampton ◽  
...  

Epidemiology ◽  
2002 ◽  
Vol 13 (1) ◽  
pp. 66-71 ◽  
Author(s):  
Celine M. Vachon ◽  
Pamela J. Mink ◽  
Carol A. Janney ◽  
Thomas A. Sellers ◽  
James R. Cerhan ◽  
...  

2013 ◽  
Vol 16 (4) ◽  
pp. 184-191 ◽  
Author(s):  
S.F. Meisel ◽  
L. Side ◽  
L. Fraser ◽  
S. Gessler ◽  
J. Wardle ◽  
...  

2006 ◽  
Vol 17 (4) ◽  
pp. 459-467 ◽  
Author(s):  
Neeraja B. Peterson ◽  
Amy Trentham-Dietz ◽  
Polly A. Newcomb ◽  
Zhi Chen ◽  
Tebeb Gebretsadik ◽  
...  

2020 ◽  
Author(s):  
L A M van Lieshout ◽  
J M J Piek ◽  
K Verwijmeren ◽  
S Houterman ◽  
A G Siebers ◽  
...  

Abstract STUDY QUESTION What is the effect of salpingectomy for ectopic pregnancy or hydrosalpinx at a young age on ovarian cancer risk compared to no salpingectomy for any reason? SUMMARY ANSWER We found no significant reduction in ovarian cancer risk after salpingectomy for ectopic pregnancy or hydrosalpinx. WHAT IS KNOWN ALREADY Salpingectomy may reduce ovarian cancer incidence, although the lag-time between intervention and therapeutic effect remains to be elucidated. STUDY DESIGN, SIZE, DURATION This nationwide population-based database study uses the Dutch pathology database to identify all women who underwent salpingectomy for ectopic pregnancy or hydrosalpinx between January 1990 and December 2012 and compared ovarian cancer incidence to a control group of women who had a benign dermal nevus removed, matched for age at the time and year of procedure. PARTICIPANTS/MATERIALS, SETTING, METHODS After selection and manual control of intervention and control group, ovarian cancer incidence was recorded. Hazard ratios (HRs) with 95% CI for the development of ovarian cancer were calculated with Cox regression analyses, both unadjusted and adjusted for age. Subgroup analyses were performed to investigate lag-time between intervention and protective effect. MAIN RESULTS AND THE ROLE OF CHANCE In all, 18 961 women were included in the intervention group; 17 106 women had a unilateral salpingectomy and 1855 had a bilateral salpingectomy. The control group consisted of 23 686 women. With 14 ovarian cancer cases in the intervention group, the incidence rate (IR) of ovarian cancer was 5.4 (95% CI 3.1–8.9) per 100 000 person-years. In the control group, there were 24 ovarian cancer cases, resulting in an IR of 7.1 (95% CI 4.7–10.5) per 100 000 person-years (P = 0.34). The age-adjusted HR for ovarian cancer was 0.76 (95% CI 0.39–1.47) after salpingectomy. Unilateral salpingectomy resulted in an age-adjusted HR of 0.81 (95% CI 0.41–1.59) and bilateral salpingectomy resulted in an age-adjusted HR of 0.43 (95% CI 0.06–3.16) based on one case. None of our subgroup analysis for lag-time resulted in a significant difference in ovarian cancer incidence between intervention and control group. The difference in ovarian cancer incidence appeared largest in women with at least 8 years of follow-up (P = 0.08). LIMITATIONS, REASONS FOR CAUTION Due to the young population, ovarian cancer incidence is low, even at the end of follow-up. Furthermore, due to the anonymous nature of the pathology registry, we were unable to adjust for confounding factors. WIDER IMPLICATIONS OF THE FINDINGS Although results did not reach statistical significance, they add to the available data on ovarian cancer incidence after salpingectomy. Our subgroup analysis suggests there may be no benefit in the first years following salpingectomy. STUDY FUNDING/COMPETING INTEREST(S) None. TRIAL REGISTRATION NUMBER N/A.


2008 ◽  
Vol 18 (3) ◽  
pp. 407-413 ◽  
Author(s):  
C. M. Nagle ◽  
C. J. Bain ◽  
A. C. Green ◽  
P. M. Webb

Reproductive and hormonal exposures are known to influence ovarian carcinogenesis, but little is known about the effect of these factors on survival. We have studied survival according to hormonal and reproductive history in a population-based cohort of 676 Australian women aged 18–79, newly diagnosed with invasive epithelial ovarian cancer in the early 1990s. In order to place our findings in context, we have also undertaken a systematic review of the pertinent literature. Detailed information about each woman's reproductive and contraceptive history was obtained from pregnancy and contraceptive calendars at the time of diagnosis. Cox regression was used to obtain multivariate adjusted hazard ratios (HR) and 95% confidence intervals (CI). A total of 419 (62%) of the 676 women died during the follow-up (giving a 5-year survival proportion of 44%). Apart from better survival for women who had ever breastfed (multivariate HR 0.74, 95% CI 0.55–0.98), we found no association between survival from invasive ovarian cancer and a range of hormonal and gynecological factors including parity, use of oral contraceptives, and histories of tubal sterilization or hysterectomy. Systematic review of the literature generally supported the lack of influence of these factors on survival from ovarian cancer. We conclude that, except for a possible survival advantage among women with a history of breastfeeding, reproductive and hormonal exposures prior to diagnosis do not influence survival from invasive ovarian cancer, in contrast to their substantial effects on etiology of this disease


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