Tubal ligation, hysterectomy, and risk of ovarian cancer. A prospective study.
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.
Hankinson
S E
SE
Channing Laboratory, Boston, MA 02115.
Hunter
D J
DJ
Colditz
G A
GA
Willett
W C
WC
Stampfer
M J
MJ
Rosner
B
B
Hennekens
C H
CH
Speizer
F E
FE
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