Tubal ligation and salpingectomy and the risk of epithelial ovarian cancer and borderline ovarian tumors: a nationwide case-control study

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 - 2015/1/1

Y1 - 2015/1/1

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

SN - 1600-0412

VL - 94

SP - 86

EP - 94

JO - Acta Obstetrica et Gynecologica

JF - Acta Obstetrica et Gynecologica

IS - 1

ER -