Collette R Lessard-Anderson1, Kathryn S Handlogten2, Rochelle J Molitor3, Sean C Dowdy4, William A Cliby5, Amy L Weaver6, Jennifer St Sauver7, Jamie N Bakkum-Gamez8. 1. Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: collettelessard@gmail.com. 2. Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: handlogten.kathryn@mayo.edu. 3. Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: rochelle.molitor@gmail.com. 4. Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: dowdy.sean@mayo.edu. 5. Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: cliby.william@mayo.edu. 6. Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: weaver@mayo.edu. 7. Division of Epidemiology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: stsauver.jennifer@mayo.edu. 8. Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: bakkum.jamie@mayo.edu.
Abstract
OBJECTIVE: To determine the effect of excisional tubal sterilization on subsequent development of serous epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC). METHODS: We performed a population-based, nested case-control study using the Rochester Epidemiology Project. We identified all patients with a diagnosis of serous EOC or PPC from 1966 through 2009. Each case was age-matched to 2 controls without either diagnosis. Odds ratios (ORs) and corresponding 95% CIs were estimated from conditional logistic regression models. Models were adjusted for prior hysterectomy, prior salpingo-oophorectomy, oral contraceptive use, endometriosis, infertility, gravidity, and parity. RESULTS: In total, we identified 194 cases of serous EOC and PPC during the study period and matched them with 388 controls (mean [SD] age, 61.4 [15.2] years). Fourteen cases (7.2%) and 46 controls (11.9%) had undergone tubal sterilization. Adjusted risk of serous EOC or PPC was slightly lower after any tubal sterilization (OR, 0.59 [95% CI, 0.29-1.17]; P=.13). The rate of excisional tubal sterilization was lower in cases than controls (2.6% vs 6.4%). Adjusted risk of serous EOC and PPC was decreased by 64% after excisional tubal sterilization (OR, 0.36 [95% CI, 0.13-1.02]; P=.054) compared with those without sterilization or with nonexcisional tubal sterilization. CONCLUSIONS: We present a population-based investigation of the effects of excisional tubal sterilization on the risk of serous EOC and PPC. Excisional methods may confer greater risk reduction than other sterilization methods.
OBJECTIVE: To determine the effect of excisional tubal sterilization on subsequent development of serous epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC). METHODS: We performed a population-based, nested case-control study using the Rochester Epidemiology Project. We identified all patients with a diagnosis of serous EOC or PPC from 1966 through 2009. Each case was age-matched to 2 controls without either diagnosis. Odds ratios (ORs) and corresponding 95% CIs were estimated from conditional logistic regression models. Models were adjusted for prior hysterectomy, prior salpingo-oophorectomy, oral contraceptive use, endometriosis, infertility, gravidity, and parity. RESULTS: In total, we identified 194 cases of serous EOC and PPC during the study period and matched them with 388 controls (mean [SD] age, 61.4 [15.2] years). Fourteen cases (7.2%) and 46 controls (11.9%) had undergone tubal sterilization. Adjusted risk of serous EOC or PPC was slightly lower after any tubal sterilization (OR, 0.59 [95% CI, 0.29-1.17]; P=.13). The rate of excisional tubal sterilization was lower in cases than controls (2.6% vs 6.4%). Adjusted risk of serous EOC and PPC was decreased by 64% after excisional tubal sterilization (OR, 0.36 [95% CI, 0.13-1.02]; P=.054) compared with those without sterilization or with nonexcisional tubal sterilization. CONCLUSIONS: We present a population-based investigation of the effects of excisional tubal sterilization on the risk of serous EOC and PPC. Excisional methods may confer greater risk reduction than other sterilization methods.
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