Skip to main content

Advertisement

Log in

Bilateral oophorectomy and risk of cancer in African American women

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Purpose

African American women are more likely to undergo hysterectomy, with or without bilateral oophorectomy, at younger ages than white women. It is well established that women who have a bilateral oophorectomy at younger ages are at reduced risk of breast cancer, and there is some evidence of an increased risk of colorectal and lung cancer.

Methods

Using data from 44,514 women in the Black Women’s Health Study, we prospectively investigated the relation of hysterectomy and oophorectomy to incidence of breast, colorectal, and lung cancer and to mortality from cancer. Hazard ratios (HRs) and 95 % confidence intervals (CIs) were estimated using Cox proportional hazards regression with control for confounding factors.

Results

During 16 years of follow-up, hysterectomy alone, relative to no hysterectomy, was not associated with risk of breast, lung, or colorectal cancer. Bilateral oophorectomy, relative to hysterectomy with ovarian conservation, was inversely associated with risk of estrogen receptor-positive (ER+) breast cancer (HR 0.62; 95 % CI 0.45–0.85) but not with ER-negative breast cancer; age at surgery and menopausal hormone use did not modify the associations. HRs for the association of bilateral oophorectomy with incidence of colorectal and lung cancer were nonsignificantly increased for women who had surgery before age 40 years and had used menopausal hormones for less than 2 years (HR 1.65; 95 % CI 0.73–3.73 for colorectal cancer and HR 1.71; 95 % CI 0.68–4.31 for lung cancer). Bilateral oophorectomy was not associated with cancer mortality.

Conclusions

Bilateral oophorectomy was associated with reduced risk of ER+ breast cancer regardless of age at surgery and use of menopausal hormones. There were nonsignificant increases in risk of colorectal and lung cancer for women with oophorectomy at younger ages and short duration of menopausal hormone use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Whiteman MK, Hillis SD, Jamieson DJ, Morrow B, Podgornik MN, Brett KM et al (2008) Inpatient hysterectomy surveillance in the United States, 2000–2004. Am J Obstet Gynecol 198(34):e1–e7

    PubMed  Google Scholar 

  2. Parker WH, Broder MS, Liu Z, Shoupe D, Farquhar C, Berek JS (2005) Ovarian conservation at the time of hysterectomy for benign disease. Obstet Gynecol 106:219–226

    Article  PubMed  Google Scholar 

  3. Rocca WA, Grossardt BR, de Andrade M, Malkasian GD, Melton LJ 3rd (2006) Survival patterns after oophorectomy in premenopausal women: a population-based cohort study. Lancet Oncol 7:821–828

    Article  PubMed  Google Scholar 

  4. Parker WH, Broder MS, Chang E, Feskanich D, Farquhar C, Liu Z et al (2009) Ovarian conservation at the time of hysterectomy and long-term health outcomes in the nurses’ health study. Obstet Gynecol 113:1027–1037

    Article  PubMed Central  PubMed  Google Scholar 

  5. Jacoby VL, Grady D, Wactawski-Wende J, Manson JE, Allison MA, Kuppermann M et al (2011) Oophorectomy vs ovarian conservation with hysterectomy: cardiovascular disease, hip fracture, and cancer in the Women’s Health Initiative Observational Study. Arch Intern Med 171:760–768

    Article  PubMed  Google Scholar 

  6. Duan L, Xu X, Koebnick C, Lacey JV Jr, Sullivan-Halley J, Templeman C et al (2012) Bilateral oophorectomy is not associated with increased mortality: the California Teachers Study. Fertil Steril 97:111–117

    Article  PubMed Central  PubMed  Google Scholar 

  7. Nichols HB, Trentham-Dietz A, Newcomb PA, Titus LJ, Egan KM, Hampton JM et al (2012) Postoophorectomy estrogen use and breast cancer risk. Obstet Gynecol 120:27–36

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  8. Trichopoulos D, MacMahon B, Cole P (1972) Menopause and breast cancer risk. J Natl Cancer Inst 48:605–613

    CAS  PubMed  Google Scholar 

  9. Irwin KL, Lee NC, Peterson HB, Rubin GL, Wingo PA, Mandel MG (1988) Hysterectomy, tubal sterilization, and the risk of breast cancer. Am J Epidemiol 127:1192–1201

    CAS  PubMed  Google Scholar 

  10. Parazzini F, Braga C, La Vecchia C, Negri E, Acerboni S, Franceschi S (1997) Hysterectomy, oophorectomy in premenopause, and risk of breast cancer. Obstet Gynecol 90:453–456

    Article  CAS  PubMed  Google Scholar 

  11. Schairer C, Persson I, Falkeborn M, Naessen T, Troisi R, Brinton LA (1997) Breast cancer risk associated with gynecologic surgery and indications for such surgery. Int J Cancer 70:150–154

    Article  CAS  PubMed  Google Scholar 

  12. Kreiger N, Sloan M, Cotterchio M, Kirsh V (1999) The risk of breast cancer following reproductive surgery. Eur J Cancer 35:97–101

    Article  CAS  PubMed  Google Scholar 

  13. Press DJ, Sullivan-Halley J, Ursin G, Deapen D, McDonald JA, Strom BL et al (2011) Breast cancer risk and ovariectomy, hysterectomy, and tubal sterilization in the women’s contraceptive and reproductive experiences study. Am J Epidemiol 173:38–47

    Article  PubMed Central  PubMed  Google Scholar 

  14. Phipps AI, Malone KE, Porter PL, Daling JR, Li CI (2008) Reproductive and hormonal risk factors for postmenopausal luminal, HER-2-overexpressing, and triple-negative breast cancer. Cancer 113:1521–1526

    Article  PubMed Central  PubMed  Google Scholar 

  15. Jacobs EJ, White E, Weiss NS (1994) Exogenous hormones, reproductive history, and colon cancer (Seattle, Washington, USA). Cancer Causes Control 5:359–366

    Article  CAS  PubMed  Google Scholar 

  16. Gallagher LG, Rosenblatt KA, Ray RM, Li W, Gao DL, Applebaum KM et al (2013) Reproductive factors and risk of lung cancer in female textile workers in Shanghai, China. Cancer Causes Control 24:1305–1314

    Article  PubMed  Google Scholar 

  17. Brinton LA, Gierach GL, Andaya A, Park Y, Schatzkin A, Hollenbeck AR et al (2011) Reproductive and hormonal factors and lung cancer risk in the NIH-AARP Diet and Health Study cohort. Cancer Epidemiol Biomarkers Prev 20:900–911

    Article  PubMed Central  PubMed  Google Scholar 

  18. Koushik A, Parent ME, Siemiatycki J (2009) Characteristics of menstruation and pregnancy and the risk of lung cancer in women. Int J Cancer 125:2428–2433

    Article  CAS  PubMed  Google Scholar 

  19. Johnson JR, Lacey JV Jr, Lazovich D, Geller MA, Schairer C, Schatzkin A et al (2009) Menopausal hormone therapy and risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 18:196–203

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Delellis Henderson K, Duan L, Sullivan-Halley J, Ma H, Clarke CA, Neuhausen SL et al (2010) Menopausal hormone therapy use and risk of invasive colon cancer: the California Teachers Study. Am J Epidemiol 171:415–425

    Article  PubMed Central  PubMed  Google Scholar 

  21. Rodriguez C, Spencer Feigelson H, Deka A, Patel AV, Jacobs EJ, Thun MJ et al (2008) Postmenopausal hormone therapy and lung cancer risk in the cancer prevention study II nutrition cohort. Cancer Epidemiol Biomarkers Prev 17:655–660

    Article  CAS  PubMed  Google Scholar 

  22. Schwartz AG, Wenzlaff AS, Prysak GM, Murphy V, Cote ML, Brooks SC et al (2007) Reproductive factors, hormone use, estrogen receptor expression and risk of non small-cell lung cancer in women. J Clin Oncol 25:5785–5792

    Article  PubMed  Google Scholar 

  23. Powell LH, Meyer P, Weiss G, Matthews KA, Santoro N, Randolph JF Jr et al (2005) Ethnic differences in past hysterectomy for benign conditions. Womens Health Issues 15:179–186

    Article  PubMed  Google Scholar 

  24. Bower JK, Schreiner PJ, Sternfeld B, Lewis CE (2009) Black-White differences in hysterectomy prevalence: the CARDIA study. Am J Public Health 99:300–307

    Article  PubMed Central  PubMed  Google Scholar 

  25. Kjerulff KH, Guzinski GM, Langenberg PW, Stolley PD, Moye NE, Kazandjian VA (1993) Hysterectomy and race. Obstet Gynecol 82:757–764

    CAS  PubMed  Google Scholar 

  26. Perera HK, Ananth CV, Richards CA, Neugut AI, Lewin SN, Lu YS et al (2013) Variation in ovarian conservation in women undergoing hysterectomy for benign indications. Obstet Gynecol 121:717–726

    Article  PubMed  Google Scholar 

  27. Moorman PG, Kuwabara H, Millikan RC, Newman B (2000) Menopausal hormones and breast cancer in a biracial population. Am J Public Health 90:966–971

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Palmer JR, Wise LA, Horton NJ, Adams-Campbell LL, Rosenberg L (2003) Dual effect of parity on breast cancer risk in African–American women. J Natl Cancer Inst 95:478–483

    Article  PubMed  Google Scholar 

  29. Woolcott CG, Maskarinec G, Pike MC, Henderson BE, Wilkens LR, Kolonel LN (2009) Breast cancer risk and hysterectomy status: the Multiethnic Cohort study. Cancer Causes Control 20:539–547

    Article  PubMed Central  PubMed  Google Scholar 

  30. Parker WH, Feskanich D, Broder MS, Chang E, Shoupe D, Farquhar CM et al (2013) Long-term mortality associated with oophorectomy compared with ovarian conservation in the Nurses’ Health Study. Obstet Gynecol 121:709–716

    Article  PubMed  Google Scholar 

  31. Peters RK, Pike MC, Chang WW, Mack TM (1990) Reproductive factors and colon cancers. Br J Cancer 61:741–748

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  32. Weiss JM, Lacey JV Jr, Shu XO, Ji BT, Hou L, Yang G et al (2008) Menstrual and reproductive factors in association with lung cancer in female lifetime nonsmokers. Am J Epidemiol 168:1319–1325

    Article  PubMed  Google Scholar 

  33. Baik CS, Strauss GM, Speizer FE, Feskanich D (2010) Reproductive factors, hormone use, and risk for lung cancer in postmenopausal women, the Nurses’ Health Study. Cancer Epidemiol Biomarkers Prev 19:2525–2533

    Article  PubMed Central  PubMed  Google Scholar 

  34. Phipps AI, Buist DS (2009) Validation of self-reported history of hysterectomy and oophorectomy among women in an integrated group practice setting. Menopause 16:576–581

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We gratefully acknowledge the continuing dedication of the Black Women’s Health Study participants and staff. This work was supported by the National Cancer Institute (R03CA162103 and R01CA058420). The content of this article is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Data on breast cancer pathology were obtained from several state cancer registries (AZ, CA, CO, CT, DE, DC, FL, GA, IL, IN, KY, LA, MD, MA, MI, NJ, NY, NC, OK, PA, SC, TN, TX, VA), and results reported do not necessarily represent their views.

Conflict of interest

The authors declare no conflicts of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Deborah A. Boggs.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Boggs, D.A., Palmer, J.R. & Rosenberg, L. Bilateral oophorectomy and risk of cancer in African American women. Cancer Causes Control 25, 507–513 (2014). https://doi.org/10.1007/s10552-014-0353-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-014-0353-y

Keywords

Navigation