Association of hysterectomy and invasive epithelial ovarian and tubal cancer: a cohort study within UKCTOCS

Abstract

Objective To investigate the association between hysterectomy with conservation of one or both adnexa and ovarian and tubal cancer. Design Prospective cohort study. Setting Thirteen NHS Trusts in England, Wales and Northern Ireland. Population A total of 202 506 postmenopausal women recruited between 2001 and 2005 to the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS) and followed up until 31 December 2014. Methods Multiple sources (questionnaires, hospital notes, Hospital Episodes Statistics, national cancer/death registries, ultrasound reports) were used to obtain accurate data on hysterectomy (with conservation of one or both adnexa) and outcomes censored at bilateral oophorectomy, death, ovarian/tubal cancer diagnosis, loss to follow up or 31 December 2014. Cox proportional hazards regression models were used to assess the association. Main outcome measures Invasive epithelial ovarian and tubal cancer (WHO 2014) on independent outcome review. Results Hysterectomy with conservation of one or both adnexa was reported in 41 912 (20.7%; 41 912/202 506) women. Median follow up was 11.1 years (interquartile range 9.96–12.04), totalling >2.17 million woman‐years. Among women who had undergone hysterectomy, 0.55% (231/41 912) were diagnosed with ovarian/tubal cancer, compared with 0.59% (945/160 594) of those with intact uterus. Multivariable analysis showed no evidence of an association between hysterectomy and invasive epithelial ovarian/tubal cancer (hazard ratio 0.98, 95% CI 0.85–1.13, P = 0.765). Conclusions This large cohort study provides further independent validation that hysterectomy is not associated with alteration of invasive epithelial ovarian and tubal cancer risk. These data are important both for clinical counselling and for refining risk prediction models. Tweetable abstract Hysterectomy does not alter risk of invasive epithelial ovarian and tubal cancer.

Ovarian tumors in women after hysterectomy for benign diseases

“…В інше дослідження були включені 202 506 жінок у менопаузі, які були набрані в період з 2001 до 2005 року для участі в британському спільному дослідженні скри нінгу раку яєчників (UKCTOCS), спостереження в рамках якого велося до 31 грудня 2014 року [25].…”

“…Аналіз чутливості, обмежений жінками, які проживали в Англії (для точності отриманих статистичних даних), продемонстрував корегований коефіцієнт ризику 0,97 (95% ДІ 0,82-1,15; P = 0,721) [25].…”