Tubal Ligation, Hysterectomy, and Risk of Ovarian Cancer: A Prospective Study

Susan E. Hankinson, David J. Hunter, Graham A. Colditz, Walter C. Willett, Meir J. Stampfer, Bernard Rosner, Frank E. Speizer, Charles H. Hennekens

Research output: Contribution to journalArticlepeer-review

296 Scopus citations

Abstract

To assess whether tubal ligation and hysterectomy affect subsequent risk of ovarian cancer. —Prospective cohort study with 12 years of follow-up. —United States, multistate. —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. —Ovarian cancer of epithelial origin confirmed by medical record review. —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 screening 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. —These data indicate that tubal ligation, and perhaps hysterectomy, may substantially reduce risk of epithelial ovarian cancer. (JAMA. 1993;270:2813-2818).

Original languageEnglish
Pages (from-to)2813-2818
Number of pages6
JournalJAMA: The Journal of the American Medical Association
Volume270
Issue number23
DOIs
StatePublished - Dec 15 1993

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