title: Long term effects of hysterectomy on mortality: nested cohort study.
abstract: OBJECTIVE
  To investigate the long term risk (mean > 20 years) of death from all causes, cardiovascular disease, and cancer in women who had or had not had a hysterectomy.
  
  
  METHODS
  Nested cohort study.
  
  
  METHODS
  Royal College of General Practitioners' oral contraception study.
  
  
  METHODS
  7410 women (3705 flagged at the NHS central registries for cancer and death who had a hysterectomy during the oral contraception study and 3705 who were flagged but did not have the operation).
  
  
  METHODS
  Mortality from all causes, cardiovascular disease, and cancer.
  
  
  RESULTS
  623 (8.4%) women had died by the end of follow-up (308 in the hysterectomy group and 315 in the non-hysterectomy group). Older women who had had a hysterectomy had a 6% reduced risk of death compared with women of a similar age who did not have the operation (adjusted hazard ratio 0.94, 95% confidence interval 0.75 to 1.18). Compared with young women who did not have a hysterectomy those who were younger at hysterectomy had an adjusted hazard ratio for all cause mortality of 0.82 (0.65 to 1.03). Hysterectomy was not associated with a significantly altered risk of mortality from cardiovascular disease or cancer regardless of age.
  
  
  CONCLUSIONS
  Hysterectomy did not increase the risk of death in the medium to long term.
authors.affiliation: Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen AB25 2AY. l.iversen@abdn.ac.uk
authors.forename: Lisa
authors.initials: L
authors.lastname: Iversen
authors.forename: Philip C
authors.initials: PC
authors.lastname: Hannaford
authors.forename: Alison M
authors.initials: AM
authors.lastname: Elliott
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Lee
mesh_terms: D000328:Adult; D000367:Age Factors; D003276:Contraceptives, Oral; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000401:mortality*
chemical_list: D003276:Contraceptives, Oral