Hysterectomy and risk of epithelial ovarian cancer by histologic type,endometriosis, and menopausal hormone therapy |
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| Institution: | 1. Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark;2. Unit of Diet, Cancer and Health, Danish Cancer Society Research Center, Copenhagen, Denmark;3. Statistics and Data Analysis, Danish Cancer Society Research Center, Copenhagen, Denmark;4. Department of Gynecology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark;1. Department of Mathematics and Statistics, Sam Houston State University, Huntsville, TX, USA;1. Prevention and Population Health Directorate, Wellbeing SA, Australia;2. Cancer Council Queensland, Queensland, Australia;3. Victorian Cancer Registry, Cancer Council Victoria, Victoria, Australia;1. Johns Hopkins Medicine, Department of Dermatology, Baltimore, MD, USA;2. University of Texas Southwestern Medical Center, Department of Dermatology, Dallas, TX, USA;3. Case Western Reserve University School of Medicine/University Hospitals Cleveland Medical Center, Department of Dermatology, Cleveland, OH, USA;1. CONACYT - Instituto Nacional de Cancerología, Mexico City, Mexico;2. Dirección de Investigación, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;3. Dirección de Investigación, Instituto Nacional de Cancerología, Mexico City, Mexico;4. Departamento de Tumores Mamarios, Instituto Nacional de Cancerología, Mexico City, Mexico;5. Servicio de Oncología, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;6. Departmento de Tumores Ginecológicos, Instituto Nacional de Cancerología, Mexico City, Mexico;7. Departmento de Tumores Urológicos, Instituto Nacional de Cancerología, Mexico City, Mexico;8. Servicio de Urología, Hospital General de México “Dr. Eduardo Liceaga”, Mexico City, Mexico;9. Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México and Instituto Nacional de Cancerología, Mexico City, Mexico;1. Department of General Practice and Centre for Cancer Research, The University of Melbourne, Parkville, Australia;2. Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Australia;3. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia;4. Primary Care Collaborative Cancer Clinical Trials Group (PC4), Carlton, Australia;1. Department of Clinical Laboratory, Sichuan Provincial Maternity and Child Health Care Hospital. The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, China;2. Department of Ultrasound, Sichuan Provincial Maternity and Child Health Care Hospital. The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, China;3. Department of Pathology, Sichuan Provincial Maternity and Child Health Care Hospital. The Affiliated Women’s and Children’s Hospital of Chengdu Medical College, China;4. Chengdu Second People’s Hospital, Chengdu 610021, Sichuan, PR China;5. Key Laboratory of Bio-Resources and Eco-Environment, Ministry of Education, Institute of Medical Genetics, College of Life Science, Sichuan University, China;6. Bio-resource Research and Utilization Joint Key Laboratory of Sichuan and Chongqing, Sichuan and Chongqing, China |
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| Abstract: | BackgroundThis nationwide, register-based case-control study investigated the association between hysterectomy and risk of epithelial ovarian cancer according to histology and by history of endometriosis and menopausal hormone therapy (MHT) use.MethodsFrom the Danish Cancer Registry, all women registered with epithelial ovarian cancer at age 40–79 years during 1998–2016 were identified (n = 6738). Each case was sex- and age-matched to 15 population controls using risk-set sampling. Information on previous hysterectomy on benign indication and potential confounders was retrieved from nationwide registers. Conditional logistic regression was used to calculate odds ratios (ORs) with 95% confidence intervals (CIs) for the association between hysterectomy and ovarian cancer according to histology, endometriosis, and use of MHT.ResultsHysterectomy was not associated with risk of epithelial ovarian cancer overall (OR=0.99; 95% CI 0.91 –1.09) but was associated with reduced risk of clear cell ovarian cancer (OR=0.46; 95% CI 0.28–0.78). In stratified analyses, decreased ORs associated with hysterectomy were seen in women with endometriosis (OR=0.74; 95% CI 0.50–1.10) and in non-users of MHT (OR=0.87; 95% CI 0.76–1.01). In contrast, among long-term MHT users, hysterectomy was associated with increased odds for ovarian cancer (OR=1.20; 95% CI 1.03–1.39).ConclusionHysterectomy was not associated with epithelial ovarian cancer overall but with reduced risk of clear cell ovarian cancer. Our findings may suggest a reduced risk of ovarian cancer after hysterectomy in women with endometriosis and in MHT non-users. Interestingly our data pointed to an increased ovarian cancer risk associated with hysterectomy among long-term users of MHT. |
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| Keywords: | Ovarian cancer Hysterectomy Endometrioses Hormone replacement therapy Post menopausal |
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