title: Effect of tubal sterilization technique on risk of serous epithelial ovarian and primary peritoneal carcinoma.
abstract: OBJECTIVE
  To determine the effect of excisional tubal sterilization on subsequent development of serous epithelial ovarian cancer (EOC) or primary peritoneal cancer (PPC).
  
  
  METHODS
  We performed a population-based, nested case-control study using the Rochester Epidemiology Project. We identified all patients with a diagnosis of serous EOC or PPC from 1966 through 2009. Each case was age-matched to 2 controls without either diagnosis. Odds ratios (ORs) and corresponding 95% CIs were estimated from conditional logistic regression models. Models were adjusted for prior hysterectomy, prior salpingo-oophorectomy, oral contraceptive use, endometriosis, infertility, gravidity, and parity.
  
  
  RESULTS
  In total, we identified 194 cases of serous EOC and PPC during the study period and matched them with 388 controls (mean [SD] age, 61.4 [15.2] years). Fourteen cases (7.2%) and 46 controls (11.9%) had undergone tubal sterilization. Adjusted risk of serous EOC or PPC was slightly lower after any tubal sterilization (OR, 0.59 [95% CI, 0.29-1.17]; P=.13). The rate of excisional tubal sterilization was lower in cases than controls (2.6% vs 6.4%). Adjusted risk of serous EOC and PPC was decreased by 64% after excisional tubal sterilization (OR, 0.36 [95% CI, 0.13-1.02]; P=.054) compared with those without sterilization or with nonexcisional tubal sterilization.
  
  
  CONCLUSIONS
  We present a population-based investigation of the effects of excisional tubal sterilization on the risk of serous EOC and PPC. Excisional methods may confer greater risk reduction than other sterilization methods.
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: collettelessard@gmail.com.
authors.forename: Collette R
authors.initials: CR
authors.lastname: Lessard-Anderson
authors.affiliation: Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: handlogten.kathryn@mayo.edu.
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Handlogten
authors.affiliation: Mayo Medical School, Mayo Clinic College of Medicine, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: rochelle.molitor@gmail.com.
authors.forename: Rochelle J
authors.initials: RJ
authors.lastname: Molitor
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: dowdy.sean@mayo.edu.
authors.forename: Sean C
authors.initials: SC
authors.lastname: Dowdy
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: cliby.william@mayo.edu.
authors.forename: William A
authors.initials: WA
authors.lastname: Cliby
authors.affiliation: Division of Biomedical Statistics and Informatics, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: weaver@mayo.edu.
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.affiliation: Division of Epidemiology, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: stsauver.jennifer@mayo.edu.
authors.forename: Jennifer St
authors.initials: JS
authors.lastname: Sauver
authors.affiliation: Division of Gynecologic Surgery, Mayo Clinic, 200 1st Street SW, Rochester, MN 55905, United States. Electronic address: bakkum.jamie@mayo.edu.
authors.forename: Jamie N
authors.initials: JN
authors.lastname: Bakkum-Gamez
mesh_terms: D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology*; D010051:Ovarian Neoplasms / Q000453:epidemiology*; D010534:Peritoneal Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D013246:Sterilization, Tubal / Q000379:methods / Q000706:statistics & numerical data*
keywords: Fimbriectomy; Salpingectomy; Serous ovarian cancer; Serous primary peritoneal cancer; Tubal sterilization