Tubal sterilization and risk of ovarian, endometrial and cervical cancer. A Danish population-based follow-up study of more than 65 000 sterilized women
Tubal sterilization and risk of ovarian, endometrial and cervical cancer. A Danish population-based follow-up study of more than 65 000 sterilized women
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DOI：
10.1093/ije/dyh046
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发表时间：
2004-06-01
影响因子：
7.7
通讯作者：
Olsen, JH
中科院分区：
文献类型：
--
作者：
Kjaer, SK;Mellemkjaer, L;Olsen, JH
背景基于人群队列，我们评估了既往做过输卵管绝育手术的妇女的癌症风险，重点是妇科癌症和癌前病变。方法使用丹麦医院出院登记表，我们确定了65 232名接受输卵管绝育手术的妇女(1977-1993)。结果卵巢癌总体风险降低(标化发病率[SIR]=0.82；95%CI：0.6，1.0)，绝育后10年以上仍有下降(SIR=0.65；95%CI：0.4，1.0)。子宫内膜癌的发生率也降低了(SIR=0.66；95%CI：0.5，1.0)，风险在随访期间继续适度降低，但无统计学意义。结论在这项全国性的人群研究中，输卵管绝育的妇女发生卵巢癌的风险降低。由于这种保护作用不会随着多年的随访而减少，我们的数据不支持‘筛查’偏见可以解释这种保护作用，但表明绝育本身可能会降低风险。在子宫内膜癌中也发现了同样的模式，但这种联系不那么强烈。
Background On the basis of a population-based cohort, we assessed the cancer risk, focusing on gynaecological cancers and pre-malignant lesions, among women with a previous tubal sterilization.Methods Using the Danish Hospital Discharge Register we identified 65 232 women who had a tubal sterilization (1977-1993). The cohort was followed for cancer occurrence, and compared with the expected number based on the national cancer incidence rates.Results The overall risk of ovarian cancer was decreased (standardized incidence ratio [SIR] = 0.82; 95% CI: 0.6, 1.0), and it was still decreased greater than or equal to10 years after the sterilization (SIR = 0.65; 95% CI: 0.4, 1.0). The rate of endometrial cancer was also decreased (SIR = 0.66; 95% CI: 0.5, 1.0), the risk continued being moderately reduced during follow-up, although it was not statistically significant.Conclusions In this nationwide, population-based study we find that women with tubal sterilization have a decreased risk of subsequent development of ovarian cancer. As the protective effect is not decreasing with years of follow-up, our data do not support that 'screening' bias can explain the protective effect, but indicate that the sterilization itself may convey a reduction in risk. The same pattern is found for endometrial cancer, the association being less strong.