Journal Article

DKFZ-2021-02557

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Endometriosis and menopausal hormone therapy impact the hysterectomy-ovarian cancer association.

Khoja, L. ; Weber, R. P. ; Group, A. O. C. S. (Collaboration Author) ; Webb, P. M. ; Jordan, S. J. ; Muthukumar, A. ; Chang-Claude, J.DKFZ* ; Fortner, R. T.DKFZ* ; Jensen, A. ; Kjaer, S. K. ; Risch, H. ; Doherty, J. A. ; Harris, H. R. ; Goodman, M. T. ; Modugno, F. ; Moysich, K. ; Berchuck, A. ; Schildkraut, J. M. ; Cramer, D. ; Terry, K. L. ; Anton-Culver, H. ; Ziogas, A. ; Phung, M. T. ; Hanley, G. E. ; Wu, A. H. ; Mukherjee, B. ; McLean, K. ; Cho, K. ; Pike, M. C. ; Pearce, C. L. ; Lee, A. W.

2022
Elsevier Amsterdam [u.a.]

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Please use a persistent id in citations: doi:10.1016/j.ygyno.2021.10.088

Abstract: To evaluate the association between hysterectomy and ovarian cancer, and to understand how hormone therapy (HT) use and endometriosis affect this association.We conducted a pooled analysis of self-reported data from 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC). Women with (n = 5350) and without ovarian cancer (n = 7544) who never used HT or exclusively used either estrogen-only therapy (ET) or estrogen+progestin therapy (EPT) were included. Risk of invasive epithelial ovarian cancer adjusted for duration of ET and EPT use and stratified on history of endometriosis was determined using odds ratios (ORs) with 95% confidence intervals (CIs).Overall and among women without endometriosis, there was a positive association between ovarian cancer risk and hysterectomy (OR = 1.19, 95% CI 1.09-1.31 and OR = 1.20, 95% CI 1.09-1.32, respectively), but no association upon adjusting for duration of ET and EPT use (OR = 1.04, 95% CI 0.94-1.16 and OR = 1.06, 95% CI 0.95-1.18, respectively). Among women with a history of endometriosis, there was a slight inverse association between hysterectomy and ovarian cancer risk (OR = 0.93, 95% CI 0.69-1.26), but this association became stronger and statistically significant after adjusting for duration of ET and EPT use (OR = 0.69, 95% CI 0.48-0.99).The hysterectomy-ovarian cancer association is complex and cannot be understood without considering duration of ET and EPT use and history of endometriosis. Failure to take these exposures into account in prior studies casts doubt on their conclusions. Overall, hysterectomy is not risk-reducing for ovarian cancer, however the inverse association among women with endometriosis warrants further investigation.

Keyword(s): Endometriosis ; Hormone therapy ; Hysterectomy ; Ovarian cancer

Note: 2022 Jan;164(1):195-201

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Contributing Institute(s):

1. C020 Epidemiologie von Krebs (C020)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2021

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Database coverage:
; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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