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. 2014 Jan;123(1):65-72.
doi: 10.1097/AOG.0000000000000061.

Ovarian cancer rates after hysterectomy with and without salpingo-oophorectomy

John K Chan  1 , Renata Urban, Angela M Capra, Vanessa Jacoby, Kathryn Osann, Alice Whittemore, Laurel A Habel
Affiliations

Ovarian cancer rates after hysterectomy with and without salpingo-oophorectomy

John K Chan et al. Obstet Gynecol. 2014 Jan.

Abstract

Objective: To estimate ovarian and peritoneal cancer rates after hysterectomy with and without salpingo-oophorectomy for benign conditions.

Methods: All patients after hysterectomy for benign disease from 1988 to 2006 in Kaiser Permanente Northern California, an integrated health organization. Incidence rates per 100,000 person-years were calculated.

Results: Of 56,692 patients, the majority (54%) underwent hysterectomy with bilateral salpingo-oophorectomy; 7% had hysterectomy with unilateral salpingo-oophorectomy, and 39% had hysterectomy alone. There were 40 ovarian and eight peritoneal cancers diagnosed during follow-up. Median age at ovarian and peritoneal cancer diagnosis was 50 and 64 years, respectively. Age-standardized rates (per 100,000 person-years) of ovarian or peritoneal cancer were 26.7 (95% confidence interval [CI] 16-37.5) for those with hysterectomy alone, 22.8 (95% CI 0.0-46.8) for hysterectomy and unilateral salpingo-oophorectomy, and 3.9 (95% CI 1.5-6.4) for hysterectomy and bilateral salpingo-oophorectomy. Rates of ovarian cancer were 26.2 (95% CI 15.5-37) for those with hysterectomy alone, 17.5 (95% CI 0.0-39.1) for hysterectomy and unilateral salpingo-oophorectomy, and 1.7 (95% CI 0.4-3) for those with hysterectomy and bilateral salpingo-oophorectomy. Compared with women undergoing hysterectomy alone, those receiving an unilateral salpingo-oophorectomy had a hazard ratio (HR) for ovarian cancer of 0.58 (95% CI 0.18-1.9) and those undergoing bilateral salpingo-oophorectomy had an HR of 0.12 (95% CI 0.05-0.28).

Conclusions: The removal of both ovaries decreases the incidence of ovarian and peritoneal cancers. Removal of one ovary might also decrease the incidence of ovarian cancer but warrants further investigation.

Level of evidence: II.

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Conflict of interest statement

Financial Disclosure: The authors did not report any potential conflicts of interest.

Figures

Figure 1
Figure 1
Incidence Rates (per 100,000 person-years) of Ovarian or Peritoneal Cancer Cancer by Type of Surgery (n=56,692) Age-adjusted to United States year 2000 female population. In age-adjusted poisson regression analyses, differences between the hysterectomy+bilateral salpingo-oophorectomy (BSO) and the hysterectomy alone groups were statistically significant (p less than 0.0001 for ovarian or peritoneal cancer; p less than 0.0001 for ovarian cancer). Differences between the hysterectomy+ unilateral salpingo-oophorectomy (USO) and the hysterectomy alone groups were not statistically significant (p= 0.60 for ovarian or peritoneal cancer; p= 0.37 for ovarian cancer only).
See this image and copyright information in PMC

References

    1. Chan JK, Cheung MK, Husain A, Teng NN, West D, Whittemore AS, et al. Patterns and progress in ovarian cancer over 14 years. Obstet Gynecol. 2006 Sep;108(3 Pt 1):521–528. - PubMed
    1. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2012. CA Cancer J Clin. 2012 Jan-Feb;62(1):10–29. - PubMed
    1. Armstrong K, Schwartz JS, Randall T, Rubin SC, Weber B. Hormone replacement therapy and life expectancy after prophylactic oophorectomy in women with BRCA1/2 mutations: a decision analysis. J Clin Oncol. 2004 Mar 15;22(6):1045–1054. - PubMed
    1. Berek JS, Chalas E, Edelson M, Moore DH, Burke WM, Cliby WA, et al. Prophylactic and risk-reducing bilateral salpingo-oophorectomy: recommendations based on risk of ovarian cancer. Obstet Gynecol. 2010 Sep;116(3):733–743. - PubMed
    1. Jacoby VL, Grady D, Wactawski-Wende J, Manson JE, Allison MA, Kuppermann M, et al. Oophorectomy vs ovarian conservation with hysterectomy: cardiovascular disease, hip fracture, and cancer in the Women's Health Initiative Observational Study. Archives of internal medicine. 2011 Apr 25;171(8):760–768. - PubMed

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