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Tubal ligation during cesarean delivery and future risk for ovarian cancer: a population-based cohort study

  • General Gynecology
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Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objective

Data regarding the effect of post-partum bilateral tubal ligation (BTL) on future risk for ovarian cancer (OC) is lacking. In the current study, we aimed to evaluate the effect of BTL during cesarean delivery (CD) on the long-term risk for OC.

Study design

A population-based cohort analysis of women above the age of 35 that underwent CD in their last delivery, comparing the long-term risk for OC between patients that had a Pomeroy excisional BTL and those that did not. OC diagnosis was pre-defined based on ICD-9 codes. Procedures occurred between the years 1991–2017. Kaplan–Meier survival curve was used to compare the cumulative incidence of OC over time and Cox proportional hazards model was constructed to control for confounders.

Results

During the study period 13,124 women met the inclusion criteria; 9438 (71.9%) of which had only CD and 3686 (28.1%) underwent CD with BTL. Despite the significantly higher incidence of maternal factors that might increase the long-term risk for OC in the BTL group (advanced maternal age, obesity, hypertensive diseases during pregnancy and diabetes mellitus), the cumulative incidence of OC cases was not significantly different between the two groups (Log-rank test p = 0.199). Likewise, when performing a Cox regression model controlling for maternal age, obesity, hypertensive diseases and diabetes, OC risk was not significantly different between the groups (adjusted HR 2.36, 95% CI 0.73–7.62; p = 0.149).

Conclusion

Despite an increased incidence of known risk factors for OC, patients that underwent BTL during CD did not have increased long-term risk for OC.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, POB 151, 84101, Beer Sheva, Israel

    Roy Kessous & Eyal Sheiner

  2. Department of Public Health, Ben-Gurion University of the Negev, Beer Sheva, Israel

    Ruslan Sergienko

Authors
  1. Roy Kessous
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  2. Ruslan Sergienko
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  3. Eyal Sheiner
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Contributions

RK: project development, data management, manuscript writing. RS: data management, data analysis, manuscript editing. ES: project development, data management, manuscript editing.

Corresponding author

Correspondence to Roy Kessous.

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Conflict of interest

Author R.K declares that he has no conflict of interest. Author S.R declares that he has no conflict of interest. Author S.E declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Appendix

Appendix

Dig

ICD code

Diagnosis

Ovary

 7300

V1043

Personal history of malignant neoplasm of ovary

 21,899

183

Malignant neoplasm of ovary and other uterine adnexa

 21,900

1830

Malignant neoplasm of ovary

 21,901

1832

Malignant neoplasm of ovary

 21,905

1838

Malignant neoplasm of other specified sites of uterine adnexa

 21,906

1839

Malignant neoplasm of uterine adnexa, unspecified

 21,759

1589

Malignant neoplasm of peritoneum, unspecified

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Kessous, R., Sergienko, R. & Sheiner, E. Tubal ligation during cesarean delivery and future risk for ovarian cancer: a population-based cohort study. Arch Gynecol Obstet 301, 1473–1477 (2020). https://doi.org/10.1007/s00404-020-05547-w

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  • DOI: https://doi.org/10.1007/s00404-020-05547-w

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