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Long-term overall and disease-specific mortality associated with benign gynecologic surgery performed at different ages. | LitMetric

Long-term overall and disease-specific mortality associated with benign gynecologic surgery performed at different ages.

Menopause

From the 1Hormonal and Reproductive Epidemiology Branch, 2Biostatistics Branch, and 3Epidemiology and Biostatistics Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD; and 4John P. Murtha Cancer Center, Walter Reed National Military Medical Center, Bethesda, MD.

Published: June 2014

AI Article Synopsis

  • The study investigates the health outcomes linked to benign bilateral salpingo-oophorectomy (BSO) performed alongside hysterectomy in women, focusing on mortality risk at different ages.
  • Data from 52,846 participants over a 22-year follow-up revealed that undergoing BSO by age 35 is linked to higher mortality risk, which decreases as the age at surgery increases.
  • The findings suggest that younger women who undergo benign gynecologic surgeries may face greater mortality risks, primarily from noncancer-related causes, although risk diminishes with age.

Article Abstract

Objective: As bilateral salpingo-oophorectomy is frequently performed with hysterectomy for nonmalignant conditions, defining health outcomes associated with benign bilateral salpingo-oophorectomy performed at different ages is critical.

Methods: We assessed mortality risk associated with benign total abdominal hysterectomy or bilateral salpingo-oophorectomy among 52,846 Breast Cancer Detection Demonstration Project follow-up study participants. Surgery and risk factor data were ascertained via baseline interview (1979-1986) and three questionnaires (1987-1998). During follow-up through December 2005 (mean, 22.1 y), 13,734 deaths were identified. We estimated hazard ratios (HRs) and 95% CIs for overall and disease-specific mortality for total abdominal hysterectomy or bilateral salpingo-oophorectomy performed by age 35, 40, 45, 50, or 55 years, compared with not having surgery, using landmark analyses and multivariable Cox regression.

Results: Undergoing bilateral salpingo-oophorectomy by age 35 years was associated with increased mortality risk (HR35 y, 1.20; 95% CI, 1.08-1.34), which decreased with age (HR40 y, 1.12; 95% CI, 1.04-1.21; HR45 y, 1.10; 95% CI, 1.03-1.17). Total abdominal hysterectomy alone performed by age 40 years was associated with increased mortality risk to a lesser extent (HR40 y, 1.08; 95% CI, 1.01-1.15). Analyses based on matched propensity scores related to having gynecologic surgery yielded similar results. Elevated mortality risks were largely attributable to noncancer causes.

Conclusions: Benign gynecologic surgeries among young women are associated with increased mortality risk, which attenuates with age.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4113222PMC
http://dx.doi.org/10.1097/GME.0000000000000118DOI Listing

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