Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: a nationwide case-control study
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Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors : a nationwide case-control study. / Madsen, C; Baandrup, Louise; Dehlendorff, Christian; Kjaer, Susanne K.
I: Acta Obstetrica et Gynecologica, Bind 94, Nr. 1, 01.2015, s. 86-94.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors
T2 - a nationwide case-control study
AU - Madsen, C
AU - Baandrup, Louise
AU - Dehlendorff, Christian
AU - Kjaer, Susanne K
N1 - © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.
PY - 2015/1
Y1 - 2015/1
N2 - OBJECTIVE: According to the recent theories on the ovarian cancer origin, any protective effect of tubal ligation may vary with histologic subtype of ovarian cancer. Furthermore, bilateral salpingectomy may represent an opportunity for surgical prevention of serous ovarian cancer.DESIGN: Nationwide register-based case-control study.SETTING: Denmark during 1982-2011.POPULATION: Cases were all Danish women diagnosed with epithelial ovarian cancer (n = 13 241) or borderline ovarian tumor (n = 3605) in the study period. Age-matched female population controls were randomly selected by risk set sampling. We required that cases and controls have no previous cancer and that controls have no previous bilateral oophorectomy.METHODS: Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals, adjusting for potential confounders.MAIN OUTCOME MEASURES: Epithelial ovarian cancer and borderline ovarian tumors stratified according to histology.RESULTS: Tubal ligation reduced overall epithelial ovarian cancer risk (odds ratios 0.87; 95% confidence interval 0.78-0.98). We observed significant risk variation according to histology (p = 0.003) with the strongest risk reductions associated with endometrioid cancer (odds ratios 0.66; 95% confidence interval 0.47-0.93) and epithelial ovarian cancer of "other" histology (odds ratios 0.60; 95% confidence interval 0.43-0.83). Tubal ligation was not associated with risk of borderline ovarian tumors. Finally, bilateral salpingectomy reduced epithelial ovarian cancer risk by 42% (odds ratios 0.58; 95% confidence interval 0.36-0.95).CONCLUSIONS: We confirmed that tubal ligation reduces the risk of epithelial ovarian cancer and particularly endometrioid cancer. To our knowledge, this is the first observational publication to report on salpingectomy and ovarian cancer risk and our promising findings warrant further investigation.
AB - OBJECTIVE: According to the recent theories on the ovarian cancer origin, any protective effect of tubal ligation may vary with histologic subtype of ovarian cancer. Furthermore, bilateral salpingectomy may represent an opportunity for surgical prevention of serous ovarian cancer.DESIGN: Nationwide register-based case-control study.SETTING: Denmark during 1982-2011.POPULATION: Cases were all Danish women diagnosed with epithelial ovarian cancer (n = 13 241) or borderline ovarian tumor (n = 3605) in the study period. Age-matched female population controls were randomly selected by risk set sampling. We required that cases and controls have no previous cancer and that controls have no previous bilateral oophorectomy.METHODS: Conditional logistic regression was used to estimate odds ratios and 95% confidence intervals, adjusting for potential confounders.MAIN OUTCOME MEASURES: Epithelial ovarian cancer and borderline ovarian tumors stratified according to histology.RESULTS: Tubal ligation reduced overall epithelial ovarian cancer risk (odds ratios 0.87; 95% confidence interval 0.78-0.98). We observed significant risk variation according to histology (p = 0.003) with the strongest risk reductions associated with endometrioid cancer (odds ratios 0.66; 95% confidence interval 0.47-0.93) and epithelial ovarian cancer of "other" histology (odds ratios 0.60; 95% confidence interval 0.43-0.83). Tubal ligation was not associated with risk of borderline ovarian tumors. Finally, bilateral salpingectomy reduced epithelial ovarian cancer risk by 42% (odds ratios 0.58; 95% confidence interval 0.36-0.95).CONCLUSIONS: We confirmed that tubal ligation reduces the risk of epithelial ovarian cancer and particularly endometrioid cancer. To our knowledge, this is the first observational publication to report on salpingectomy and ovarian cancer risk and our promising findings warrant further investigation.
KW - Adult
KW - Age Distribution
KW - Aged
KW - Aged, 80 and over
KW - Case-Control Studies
KW - Confidence Intervals
KW - Denmark
KW - Female
KW - Humans
KW - Incidence
KW - Logistic Models
KW - Middle Aged
KW - Neoplasm Invasiveness
KW - Neoplasm Staging
KW - Neoplasms, Glandular and Epithelial
KW - Odds Ratio
KW - Ovarian Neoplasms
KW - Registries
KW - Risk Reduction Behavior
KW - Salpingectomy
KW - Sterilization, Tubal
U2 - 10.1111/aogs.12516
DO - 10.1111/aogs.12516
M3 - Journal article
C2 - 25256594
VL - 94
SP - 86
EP - 94
JO - Acta Obstetricia et Gynecologica Scandinavica
JF - Acta Obstetricia et Gynecologica Scandinavica
SN - 0001-6349
IS - 1
ER -
ID: 162855758