Long-term cancer risk after hysterectomy on benign indications: population-based cohort study.

Long-term cancer risk after hysterectomy on benign indications: population-based cohort study.

Int J Cancer. 2016 Jan 21;

Authors: Altman D, Yin L, Falconer H

Abstract
Hysterectomy on benign indications is associated with an increased risk for adverse health effects. However, little is known about the association between hysterectomy and subsequent cancer occurrence later in life. The purpose of this study was to assess the effect of hysterectomy on the incidence of cancer. In this population-based cohort study, we used data on 111595 hysterectomized and 5379843 non-hysterectomized women from nationwide Swedish health care registers including the Inpatient Register, the Cancer Register and the Cause of Death Register in-between 1973-2009. Hysterectomy with or without concomitant bilateral salpingo-oophorectomy (BSO) performed on benign indications was considered as exposure and incidence of primary cancers was used as outcome meassure. Rare primary cancers (<100 cases for the two groups combined) were excluded from analysis. A marginal risk reduction for any cancer was observed for women with previous hysterectomy and for those with hysterectomy and concurrent BSO (HR 0.93, 95% CI 0.91-0.95 and HR 0.92, 95% CI 0.87-0.96 respectively). Compared to non-hysterectomized women, significant risks were observed for thyroid cancer (HR 1.76, 95% CI 1.45-2.14). For both hysterectomy, and hysterectomy with BSO, an association with brain cancer was observed (HR 1.48, 95% CI 1.32-1.65 and HR 1.45, 95% CI 1.15-1.83 respectively). Hysterectomy, with or without BSO, was not associated with breast, lung or gastrointestinal cancer. We conclude that hysterectomy on benign indications is associated with an increased risk for thyroid and brain cancer later in life. Further research efforts are needed to identify patient groups at risk of malignancy following a hysterectomy. This article is protected by copyright. All rights reserved.

PMID: 26800386 [PubMed - as supplied by publisher]

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