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The Association Between Hysterectomy and Ovarian Cancer Risk: A Population-Based Record-Linkage Study.
- Source :
-
Journal of the National Cancer Institute [J Natl Cancer Inst] 2019 Oct 01; Vol. 111 (10), pp. 1097-1103. - Publication Year :
- 2019
-
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.<br />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 (nā=ā1640) 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.<br />Results: Hysterectomy without oophorectomy (nā=ā78 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.<br />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.<br /> (© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Australia epidemiology
Comorbidity
Female
Humans
Hysterectomy adverse effects
Middle Aged
Ovariectomy
Population Surveillance
Risk Assessment
Risk Factors
Young Adult
Hysterectomy statistics & numerical data
Ovarian Neoplasms epidemiology
Ovarian Neoplasms etiology
Subjects
Details
- Language :
- English
- ISSN :
- 1460-2105
- Volume :
- 111
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of the National Cancer Institute
- Publication Type :
- Academic Journal
- Accession number :
- 30753695
- Full Text :
- https://doi.org/10.1093/jnci/djz015