title: Tubal Ligation and Risk of Endometrial Cancer: Findings From the Women's Health Initiative.
abstract: OBJECTIVE
  Bilateral tubal ligation (BTL) is a common form of birth control in the United States. There are limited, contradictory data examining BTL and the risk of endometrial cancer and none examining type I and type II cancers separately. We investigated the association between BTL and endometrial cancer risk using the Women's Health Initiative (WHI) Observational and Dietary Modification Studies.
  
  
  METHODS
  Demographic information and history of BTL were obtained from the baseline questionnaires from 76,483 WHI participants in the Observational and Dietary Modification Studies. Univariable and multivariable models were used to examine the association of BTL with type I and type II endometrial cancers.
  
  
  RESULTS
  A total of 1137 women were diagnosed with incident endometrial cancer (972 type I and 128 type II) during a mean follow-up of 11.3 years. Overall, 14,499 (19%) women had undergone BTL. There were no statistically significant associations noted between BTL and age at BTL for type I or type II cancers.
  
  
  CONCLUSIONS
  We examined the largest patient cohort to date in an effort to determine the impact of BTL on endometrial cancer risk. In the WHI trial, we observed no overall effect of BTL on the risk of type I or type II endometrial cancer, suggesting that patients undergoing this popular birth control method likely do not have an associated change in their baseline risk for endometrial cancer.
authors.affiliation: *Division of Gynecologic Oncology, Department of Oncology, Karmanos Cancer Institute and Wayne State University, Detroit, MI; †Center for Biostatistics, Ohio State University, Columbus, OH; ‡Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY; §Division of Reproductive Endocrinology and Infertility, University of Texas, Health Sciences Center, San Antonio, TX; ∥Department of Oncology, Karmanos Cancer Institute and Wayne State University; and ¶Population Studies and Disparities Program, Karmanos Cancer Institute, Detroit, MI.
authors.forename: Ira
authors.initials: I
authors.lastname: Winer
authors.forename: Amy
authors.initials: A
authors.lastname: Lehman
authors.forename: Jean
authors.initials: J
authors.lastname: Wactawski-Wende
authors.forename: Randal
authors.initials: R
authors.lastname: Robinson
authors.forename: Michael
authors.initials: M
authors.lastname: Simon
authors.forename: Michele
authors.initials: M
authors.lastname: Cote
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D017698:Postmenopause; D011379:Prognosis; D012307:Risk Factors; D013246:Sterilization, Tubal / Q000009:adverse effects*; D014481:United States / Q000453:epidemiology; D016387:Women's Health
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