Tubal ligation, hysterectomy, and risk of ovarian cancer. A prospective study
Hankinson, S.E.; Hunter, D.J.; Colditz, G.A.; Willett, W.C.; Stampfer, M.J.; Rosner, B.; Hennekens, C.H.; Speizer, F.E.
JAMA 270(23): 2813-2818
1993
ISSN/ISBN: 0098-7484 PMID: 8133619 Document Number: 334807
Objective sbd To assess whether tubal ligation and hysterectomy affect subsequent risk of ovarian cancer. Design sbd Prospective cohort study with 12 years of follow-up. Setting sbd United States, multistate. Participants sbd A total of 121,700 female registered nurses who were 30 to 55 years of age in 1976; the follow-up rate was 90% as of 1988. Main Outcome Measure sbd Ovarian cancer of epithelial origin confirmed by medical record review. Results. We observed a strong inverse association between tubal ligation and ovarian cancer, which persisted after adjustment for age, oral contraceptive use, parity, and other ovarian cancer risk factors (multivariate relative risk (RR), 0.33; 95% confidence interval (CI), 0.16 to 0.64). The association was similar when we assessed tubal ligation status at the baseline questionnaire and excluded cases in the first 4 years to eliminate any possible short-term decrease in risk due to sceening of the ovaries during ligation surgery. We noted a weaker inverse association between simple hysterectomy and ovarian cancer (RR, 0.67; 95% CI, 0.45 to 1.00). Neither vasectomy nor condom use by a partner was associated with risk of ovarian cancer. Conclusions sbd These data indicate that tubal ligation, and perhaps hysterectomy, may substantially reduce risk of epithelial ovarian cancer.