Journal of Ovarian Research May 15th: Tubal ligation, hysterectomy and ovarian cancer: A meta-analysis

 Blogger's Note: included in the study are references to hereditary ovarian cancer - BRCA's but not Lynch Syndrome
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Journal of Ovarian Research Tubal ligation, hysterectomy and ovarian cancer: A meta-analysis

Introduction
Ovarian cancer is the fifth leading cause of cancer death in US women [1], yet primary prevention recommendations are limited. Gynecological surgeries including tubal ligation and hysterectomy may alter ovarian cancer risk by protecting the ovary from ascending carcinogens or damaging the utero-ovarian artery altering hormonal function. In addition, tubal ligation may increase immunity against the surface glycoprotein human mucin 1 (MUC1) [2-4]. While tubal ligation and hysterectomy generally have been found to be inversely associated with ovarian cancer, effect estimates vary between studies and little is
known about potential effect modifiers of these associations. Therefore, we conducted a meta-analysis of the association between ovarian cancer and tubal ligation as well as hysterectomy.

Results
......In secondary analyses, the association between tubal ligation and ovarian cancer risk was stronger for endometrioid tumors compared to serous tumors.

Conclusion

Observational epidemiologic evidence strongly supports that tubal ligation and hysterectomy are associated with a decrease in the risk of ovarian cancer, by approximately 26-30%. Additional research is needed to determine whether the association between tubal ligation and hysterectomy on ovarian cancer risk differs by individual, surgical, and tumor characteristics.

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abstract: Tubal ligation and the risk of ovarian cancer: review and meta-analysis — Hum Reprod Update (serous/mucinous/endometrioid)

BACKGROUND The reduction of ovarian cancer (OC) risk in women with a history of tubal ligation (TL) has been reported repeatedly, mostly on small populations. We have aimed to provide a critical overview of the studies available to date and to conduct a meta-analysis.

METHODS There were 40 relevant studies identified. The studies were divided into two groups for strict and extended meta-analysis, respectively. Subgroup analysis was performed for age, time dependency since TL, histological types of OC and BReast CAncer (BRCA) mutation.

RESULTS Meta-analysis of 13 strictly selected studies showed a reduced risk of epithelial OC by 34%. The protective effect of TL was confirmed even in a subgroup of women 10–14 years after the procedure. The risk reduction was confirmed for the endometrioid (RR = 0.40) and serous (RR = 0.73) cancers but not for mucinous.

CONCLUSIONS The review of relevant articles, as well as the meta-analysis of selected studies, yields consistent data on a significant reduction of OC risk in women who had undergone TL. The results of this meta-analysis should provide an impulse for further research on the etiology of ovarian epithelial cancers, focusing particularly on the importance of retrograde transport of endometrial cells.

media - Ovarian cancer researchers request practice changes to protect against ovarian cancer: deaths could be reduced 50 percent over 20 years

"They are asking all BC gynecologists to change surgical practice to fully remove the fallopian tube when performing hysterectomy or tubal ligation. Current practice leaves the fallopian tube in place for many types of hysterectomy and tubal ligation. This is a matter of convention, not need."

The incidence of major complications after the performance of extensive upper abdominal surgical procedures during primary cytoreduction of advanced ovarian, tubal, and peritoneal carcinomas

Objective.

To assess the morbidity and mortality associated with extensive upper abdominal surgery (EUAS) performed during primary cytoreduction for advanced ovarian carcinoma.

Risk factors for carcinoma of the fallopian tube in women with and without a germline BRCA mutation

Reminder on stats: < 1.0 is decreased risk; > 1.0 is increased risk; OR=overall risk; edited some stats for ease of reading - see abstract/read more:

Conclusions

Parity and oral contraceptive use are associated with reduced risks of fallopian tube cancer. In contrast, hormone replacement therapy may be associated with an increase in the risk of fallopian tube cancer.