title: Tubal ligation, hysterectomy, and risk of ovarian cancer. A prospective study.
abstract: OBJECTIVE
  To assess whether tubal ligation and hysterectomy affect subsequent risk of ovarian cancer.
  
  
  METHODS
  Prospective cohort study with 12 years of follow-up.
  
  
  METHODS
  United States, multistate.
  
  
  METHODS
  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.
  
  
  METHODS
  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 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.
  
  
  CONCLUSIONS
  These data indicate that tubal ligation, and perhaps hysterectomy, may substantially reduce risk of epithelial ovarian cancer.
authors.affiliation: Channing Laboratory, Boston, MA 02115.
authors.forename: S E
authors.initials: SE
authors.lastname: Hankinson
authors.forename: D J
authors.initials: DJ
authors.lastname: Hunter
authors.forename: G A
authors.initials: GA
authors.lastname: Colditz
authors.forename: W C
authors.initials: WC
authors.lastname: Willett
authors.forename: M J
authors.initials: MJ
authors.lastname: Stampfer
authors.forename: B
authors.initials: B
authors.lastname: Rosner
authors.forename: C H
authors.initials: CH
authors.lastname: Hennekens
authors.forename: F E
authors.initials: FE
authors.lastname: Speizer
mesh_terms: D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000706:statistics & numerical data; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology*; D011446:Prospective Studies; D012307:Risk Factors; D013246:Sterilization, Tubal / Q000706:statistics & numerical data