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Cancer Risk After Midurethral Sling Surgery Using Polypropylene Mesh
- Source :
- Obstetrics & Gynecology. 131:469-474
- Publication Year :
- 2018
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2018.
-
Abstract
- Objective To assess whether there is any association between the implantation of synthetic polypropylene mesh slings for the treatment of stress urinary incontinence (SUI) and risk of cancer. Methods We performed a nationwide cohort study based on the general female population in Sweden. All women entered the observational period as unexposed on January 1, 1997, and contributed person-time as unexposed unless they underwent a midurethral sling procedure for SUI, after which they contributed person-time as exposed until first occurrence of any cancer, death, emigration, or end of the observational period (December 31, 2009). Occurrence of primary cancer was ascertained from the Cancer Register. Hazard ratios (HRs) with 95% CIs were calculated by Cox proportional hazards regression. Results The final study population included 5,385,186 women, including 20,905 exposed, encompassing a total of 44,012,936 person-years at risk. Other than an inverse association with rectal cancer (HR 0.5, 95% CI 0.3-0.8), there were no significant differences in risk between exposed and unexposed women for pelvic organ cancers including ovarian (HR 0.8, 95% CI 0.5-1.2), endometrial (HR 1.1, 95% CI 0.8-1.4), cervical (HR 0.4, 95% CI 0.2-1.0), bladder, and urethra (HR 0.7, 95% CI 0.4-1.2). No significant association was observed between exposed women and primary cancer in any organ system when compared with unexposed women. The relative risk for cancer after exposure showed little variation over time except for an inverse overall correlation within the first 4 years of surgery (HR 0.7, 95% CI 0.7-0.8). The incidence rates per 100,000 person-years (95% CIs) for exposed vs unexposed women were 20.5 (14.3-29.5) vs 21.0 (20.6-21.5) for rectal cancer, 25.5 (18.4-35.3) vs 19.8 (19.4-20.2) for ovarian cancer, 65.0 (53.0-79.8) vs 33.1 (32.6-33.7) for endometrial cancer, 5.7 (2.8-11.3) vs 11.9 (11.6-12.2) for cervical cancer, and 19.1 (13.1-27.8) vs 13.3 (13.0-13.7) for bladder and urethra cancer. Conclusion Our results suggest that midurethral polypropylene sling surgery for SUI is not associated with an increased cancer risk later in life.
- Subjects :
- Adult
medicine.medical_specialty
Adolescent
Colorectal cancer
Urinary Incontinence, Stress
030232 urology & nephrology
Urinary incontinence
Polypropylenes
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine
Humans
Registries
Aged
Pelvic Neoplasms
Proportional Hazards Models
Aged, 80 and over
Sweden
Cervical cancer
Suburethral Slings
030219 obstetrics & reproductive medicine
business.industry
Incidence
Endometrial cancer
Hazard ratio
Obstetrics and Gynecology
General Medicine
Middle Aged
Surgical Mesh
medicine.disease
Surgery
Relative risk
Population study
Female
medicine.symptom
Ovarian cancer
business
Follow-Up Studies
Subjects
Details
- ISSN :
- 00297844
- Volume :
- 131
- Database :
- OpenAIRE
- Journal :
- Obstetrics & Gynecology
- Accession number :
- edsair.doi.dedup.....e6c851ac82eb9bd831919e8e26c44826