AACR: Tubal Ligation and Hysterectomy Reduce Ovarian Cancer Risk Associated with Nulliparity
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AACR: Tubal Ligation and Hysterectomy Reduce Ovarian Cancer Risk Associated with Nulliparity

By Peggy Peck

WASHINGTON, DC -- July 16, 2003 -- Research from the University of Illinois suggests that tubal ligation can influence ovarian cancer risk and the association may not be related to the number of menstrual cycles.

Previous research found an association between lifetime menstrual cycles and risk of ovarian cancer. The new findings were reported here July 13th at the 94th Annual Meeting of the American Association for Cancer Research.

Dr. Garth H. Rauscher, a postdoctoral fellow in the division of epidemiology and biostatistics at the University of Illinois, in Chicago, United States, said in an interview that tubal ligation was associated with a 40% reduction in risk of ovarian cancer in a population-based case control study of women who achieved at least 1 live birth during the study period. Hysterectomy was also associated with a reduced risk of ovarian cancer, he said.

"We are not sure of the exact mechanism. But it appears that there is some factor related to surgery -- perhaps cauterization -- that confers protection," he added.

Dr. Rauscher and colleagues evaluated the effect of parity, tubal ligation/hysterectomy, and number of live births among 351 incident ovarian cancer cases and 501 controls. Both cases and controls had at least 1 live birth during the study period. He and his colleagues conducted interviews with 75% of cases and 53% of controls.

The researchers estimated relative risk (RR) from odds ratios (ORs) in logistic regression for surgery history alone and in combination with parity history while controlling for age, race, use of talcum powder, oral contraceptive use, and history of ovarian cysts.

Thirty-two percent of women in the control group had a history of surgery; 16% were nulliparous, and 23% had at least 4 live births. Compared to multiparous (4 or more births) women with a history of surgery, nulliparous women without surgery had a 4-fold increased incidence (RR=4.2, 95% CI: 2.3, 7.7), while nulliparous women with a surgery history were not at increased risk (RR=1.6, 95% CI: 0.6, 4.7).

Thus, Dr. Rauscher said, "surgery apparently overcomes the increased risk associated with nulliparity."

Tubal ligation (RR = 0.6, 95% CI: 0.4, 0.9) and hysterectomy (RR of 0.8, 95% CI: 0.5, 1.3) were both associated with a decreased incidence of ovarian cancer.

[Study title: Tubal Ligation, Hysterectomy, and Interactions with Parity in the Incidence of Ovarian Cancer. Abstract R1551]

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