Nan Huo1, Carin Y Smith2, Liliana Gazzuola Rocca1, Walter A Rocca3, Michelle M Mielke4. 1. Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN. 2. Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN. 3. Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Department of Neurology, Mayo Clinic, Rochester, Minnesota; Mayo Clinic Specialized Research Center of Excellence on Sex Differences, Mayo Clinic, Rochester, Minnesota. 4. Division of Epidemiology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN; Department of Neurology, Mayo Clinic, Rochester, Minnesota; Mayo Clinic Specialized Research Center of Excellence on Sex Differences, Mayo Clinic, Rochester, Minnesota. Electronic address: Mielke.Michelle@mayo.edu.
Abstract
BACKGROUND: Hysterectomy is one of the most frequent gynecologic surgeries in the United States. Women undergoing hysterectomy are commonly offered bilateral oophorectomy for ovarian and breast cancer prevention. Although bilateral oophorectomy may dramatically reduce the risk of gynecologic cancers, some studies suggested that bilateral oophorectomy may be associated with an increased risk of other types of cancer, such as lung cancer and colorectal cancer. However, the results are conflicting. OBJECTIVE: To study the association between bilateral oophorectomy and the risk of subsequent cancer of any type. STUDY DESIGN: This population-based cohort study included all premenopausal women who underwent bilateral oophorectomy for a nonmalignant indication before the age of 50, between January 1, 1988 and December 31, 2007 in Olmsted County, Minnesota, and a random sample of age-matched (±1 year) referent women who did not undergo bilateral oophorectomy. Women with cancer before oophorectomy (or index date) or within 6 months after the index date were excluded. Time-to-event analyses were performed to assess the risk of de novo cancer. Cancer diagnosis and type were confirmed using medical record review. RESULTS: Over a median follow-up of 18 years, the risk of any cancer did not significantly differ between the 1562 women who underwent bilateral oophorectomy before natural menopause and the 1610 referent women (adjusted hazard ratio, 0.82; 95% confidence interval, 0.66-1.03). However, women who underwent bilateral oophorectomy had a decreased risk of gynecologic cancers (adjusted hazard ratio, 0.15; 95% confidence interval, 0.06-0.34) but not of nongynecologic cancers (adjusted hazard ratio, 0.99; 95% confidence interval, 0.78-1.26). In particular, the risk of breast cancer, gastrointestinal cancer, and lung cancer did not differ between these 2 cohorts. Use of estrogen therapy through the age of 50 years in women who underwent bilateral oophorectomy did not modify the results. CONCLUSION: Women who underwent bilateral oophorectomy before menopause have a reduced risk of gynecologic cancer but not of other types of cancer including breast cancer. Women at average risk of ovarian cancer should not consider bilateral oophorectomy for the prevention of breast cancer or other nongynecologic cancers.
BACKGROUND: Hysterectomy is one of the most frequent gynecologic surgeries in the United States. Women undergoing hysterectomy are commonly offered bilateral oophorectomy for ovarian and breast cancer prevention. Although bilateral oophorectomy may dramatically reduce the risk of gynecologic cancers, some studies suggested that bilateral oophorectomy may be associated with an increased risk of other types of cancer, such as lung cancer and colorectal cancer. However, the results are conflicting. OBJECTIVE: To study the association between bilateral oophorectomy and the risk of subsequent cancer of any type. STUDY DESIGN: This population-based cohort study included all premenopausal women who underwent bilateral oophorectomy for a nonmalignant indication before the age of 50, between January 1, 1988 and December 31, 2007 in Olmsted County, Minnesota, and a random sample of age-matched (±1 year) referent women who did not undergo bilateral oophorectomy. Women with cancer before oophorectomy (or index date) or within 6 months after the index date were excluded. Time-to-event analyses were performed to assess the risk of de novo cancer. Cancer diagnosis and type were confirmed using medical record review. RESULTS: Over a median follow-up of 18 years, the risk of any cancer did not significantly differ between the 1562 women who underwent bilateral oophorectomy before natural menopause and the 1610 referent women (adjusted hazard ratio, 0.82; 95% confidence interval, 0.66-1.03). However, women who underwent bilateral oophorectomy had a decreased risk of gynecologic cancers (adjusted hazard ratio, 0.15; 95% confidence interval, 0.06-0.34) but not of nongynecologic cancers (adjusted hazard ratio, 0.99; 95% confidence interval, 0.78-1.26). In particular, the risk of breast cancer, gastrointestinal cancer, and lung cancer did not differ between these 2 cohorts. Use of estrogen therapy through the age of 50 years in women who underwent bilateral oophorectomy did not modify the results. CONCLUSION: Women who underwent bilateral oophorectomy before menopause have a reduced risk of gynecologic cancer but not of other types of cancer including breast cancer. Women at average risk of ovarian cancer should not consider bilateral oophorectomy for the prevention of breast cancer or other nongynecologic cancers.
Authors: Jennifer L St Sauver; Brandon R Grossardt; Cynthia L Leibson; Barbara P Yawn; L Joseph Melton; Walter A Rocca Journal: Mayo Clin Proc Date: 2012-02 Impact factor: 7.616
Authors: Susan M Domchek; Tara M Friebel; Christian F Singer; D Gareth Evans; Henry T Lynch; Claudine Isaacs; Judy E Garber; Susan L Neuhausen; Ellen Matloff; Rosalind Eeles; Gabriella Pichert; Laura Van t'veer; Nadine Tung; Jeffrey N Weitzel; Fergus J Couch; Wendy S Rubinstein; Patricia A Ganz; Mary B Daly; Olufunmilayo I Olopade; Gail Tomlinson; Joellen Schildkraut; Joanne L Blum; Timothy R Rebbeck Journal: JAMA Date: 2010-09-01 Impact factor: 56.272
Authors: Jennifer L St Sauver; Brandon R Grossardt; Barbara P Yawn; L Joseph Melton; Walter A Rocca Journal: Am J Epidemiol Date: 2011-03-23 Impact factor: 4.897
Authors: Hazel B Nichols; Kala Visvanathan; Polly A Newcomb; John M Hampton; Kathleen M Egan; Linda Titus-Ernstoff; Amy Trentham-Dietz Journal: Am J Epidemiol Date: 2011-03-23 Impact factor: 4.897
Authors: Ingrid E Fakkert; Marian J E Mourits; Liesbeth Jansen; Dorina M van der Kolk; Kees Meijer; Jan C Oosterwijk; Bert van der Vegt; Marcel J W Greuter; Geertruida H de Bock Journal: Cancer Prev Res (Phila) Date: 2012-09-25
Authors: Richard A Goodman; Samuel F Posner; Elbert S Huang; Anand K Parekh; Howard K Koh Journal: Prev Chronic Dis Date: 2013-04-25 Impact factor: 2.830
Authors: Walter A Rocca; Liliana Gazzuola-Rocca; Carin Y Smith; Brandon R Grossardt; Stephanie S Faubion; Lynne T Shuster; James L Kirkland; Elizabeth A Stewart; Virginia M Miller Journal: Mayo Clin Proc Date: 2016-09-29 Impact factor: 7.616