Ovarian Conservation at the Time of Hysterectomy and Long-Term Health Outcomes in the Nurses’ Health Study

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dc.contributor.author Parker, WH en
dc.contributor.author Broder, MS en
dc.contributor.author Change, E en
dc.contributor.author Feskanich, D en
dc.contributor.author Farquhar, Cynthia en
dc.contributor.author Liu, Z en
dc.contributor.author Berek, J en
dc.contributor.author Hankinson, S en
dc.contributor.author Manson, J en
dc.date.accessioned 2012-03-07T19:21:55Z en
dc.date.issued 2009 en
dc.identifier.citation OBSTETRICS AND GYNECOLOGY 113(5):1027-1037 01 May 2009 en
dc.identifier.issn 0029-7844 en
dc.identifier.uri http://hdl.handle.net/2292/13258 en
dc.description.abstract OBJECTIVE: To report long-term health outcomes and mortality after oophorectomy or ovarian conservation. METHODS: We conducted a prospective, observational study of 29,380 women participants of the Nurses’ Health Study who had a hysterectomy for benign disease; 16,345 (55.6%) had hysterectomy with bilateral oophorectomy, and 13,035 (44.4%) had hysterectomy with ovarian conservation. We evaluated incident events or death due to coronary heart disease (CHD), stroke, breast cancer, ovarian cancer, lung cancer, colorectal cancer, total cancers, hip fracture, pulmonary embolus, and death from all causes. RESULTS: Over 24 years of follow-up, for women with hysterectomy and bilateral oophorectomy compared with ovarian conservation, the multivariable hazard ratios (HRs) were 1.12 (95% confidence interval [CI] 1.03–1.21) for total mortality, 1.17 (95% CI 1.02–1.35) for fatal plus nonfatal CHD, and 1.14 (95% CI 0.98 –1.33) for stroke. Although the risks of breast (HR 0.75, 95% CI 0.68 – 0.84), ovarian (HR 0.04, 95% CI 0.01– 0.09, number needed to treat 220), and total cancers (HR 0.90, 95% CI 0.84 – 0.96) decreased after oophorectomy, lung cancer incidence (HR 1.26, 95% CI 1.02–1.56, number needed to harm 190), and total cancer mortality (HR 1.17, 95% CI 1.04 –1.32) increased. For those never having used estrogen therapy, bilateral oophorectomy before age 50 years was associated with an increased risk of all-cause mortality, CHD, and stroke. With an approximate 35-year life span after surgery, one additional death would be expected for every nine oophorectomies performed. CONCLUSION: Compared with ovarian conservation, bilateral oophorectomy at the time of hysterectomy for benign disease is associated with a decreased risk of breast and ovarian cancer but an increased risk of allcause mortality, fatal and nonfatal coronary heart disease, and lung cancer. In no analysis or age group was oophorectomy associated with increased survival. en
dc.publisher The American College of Obstetricians and Gynecologists en
dc.relation.ispartofseries Obstetrics and Gynecology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Ovarian Conservation at the Time of Hysterectomy and Long-Term Health Outcomes in the Nurses’ Health Study en
dc.type Journal Article en
dc.identifier.doi 10.1097/AOG.0b013e3181a11c64 en
pubs.issue 5 en
pubs.begin-page 1027 en
pubs.volume 113 en
dc.rights.holder Copyright: The American College of Obstetricians and Gynecologists en
dc.identifier.pmid 19384117 en
pubs.end-page 1037 en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Article en
pubs.elements-id 223342 en
pubs.org-id Medical and Health Sciences en
pubs.org-id School of Medicine en
pubs.org-id Obstetrics and Gynaecology en
pubs.record-created-at-source-date 2010-09-01 en
pubs.dimensions-id 19384117 en

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