Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis

Marjolein Hermens; Anne M van Altena; Johan Bulten; Huib A A M van Vliet; Albert G Siebers; Ruud L M Bekkers

doi:10.1016/j.fertnstert.2022.01.030

Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis

Marjolein Hermens^*, Anne M van Altena, Johan Bulten, Huib A A M van Vliet, Albert G Siebers, Ruud L M Bekkers

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To assess the incidence of ovarian cancer in women with histologically proven endometriosis after bilateral salpingo-oophorectomy (BSO).

DESIGN: Retrospective nationwide cohort study.

SETTING: Dutch pathology database.

PATIENT(S): Women with histologically proven endometriosis who had undergone BSO between 1990 and 2015 (n = 7,984). This study consists of 2 control cohorts: women with histologically proven endometriosis without BSO (n = 42,633) and women with a benign dermal nevus (n = 132,535).

INTERVENTION(S): Observational study.

MAIN OUTCOME MEASURE(S): Number of histologic diagnoses of (extra-)ovarian cancers. Incidence rate ratios (IRR) were estimated for (extra-)ovarian cancer. The number needed to treat was calculated.

RESULT(S): We identified 9 (0.1%) (extra-)ovarian cancers in the BSO cohort and 170 (0.4%) and 444 (0.3%) ovarian cancers in the endometriosis and nevus control cohorts, respectively. We found an age-adjusted IRR of 0.34 (95% confidence interval [CI], 0.15-0.76) when the BSO cohort was compared with the endometriosis cohort. Comparing the BSO cohort with the nevus control cohort resulted in an age-adjusted IRR of 0.38 (95% CI, 0.17-0.85). The number needed to treat when the BSO cohort was compared with the endometriosis control cohort was 351 (95% CI, 272-591).

CONCLUSION(S): In this nationwide study, we found that the (extra-)ovarian cancer incidence in women with histologically proven endometriosis decreased to less than the background population risk after BSO. Additionally, we found a significant reduction of the incidence of ovarian cancer when compared with women with histologically proven endometriosis without BSO. Endometriosis surgery could in the future be a preventive strategy in women with endometriosis and a high-risk profile for ovarian cancer.

Original language	English
Pages (from-to)	938-945
Number of pages	8
Journal	Fertility and Sterility
Volume	117
Issue number	5
Early online date	14 Mar 2022
DOIs	https://doi.org/10.1016/j.fertnstert.2022.01.030
Publication status	Published - May 2022

Keywords

Ovarian cancer
RISK
bilateral salpingo-oophorectomy
endometriosis
risk

Access to Document

10.1016/j.fertnstert.2022.01.030Licence: Free access - publisher

Cite this

@article{1d01aecb5a364a05bf71819f349c8e0b,

title = "Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis",

abstract = "OBJECTIVE: To assess the incidence of ovarian cancer in women with histologically proven endometriosis after bilateral salpingo-oophorectomy (BSO).DESIGN: Retrospective nationwide cohort study.SETTING: Dutch pathology database.PATIENT(S): Women with histologically proven endometriosis who had undergone BSO between 1990 and 2015 (n = 7,984). This study consists of 2 control cohorts: women with histologically proven endometriosis without BSO (n = 42,633) and women with a benign dermal nevus (n = 132,535).INTERVENTION(S): Observational study.MAIN OUTCOME MEASURE(S): Number of histologic diagnoses of (extra-)ovarian cancers. Incidence rate ratios (IRR) were estimated for (extra-)ovarian cancer. The number needed to treat was calculated.RESULT(S): We identified 9 (0.1%) (extra-)ovarian cancers in the BSO cohort and 170 (0.4%) and 444 (0.3%) ovarian cancers in the endometriosis and nevus control cohorts, respectively. We found an age-adjusted IRR of 0.34 (95% confidence interval [CI], 0.15-0.76) when the BSO cohort was compared with the endometriosis cohort. Comparing the BSO cohort with the nevus control cohort resulted in an age-adjusted IRR of 0.38 (95% CI, 0.17-0.85). The number needed to treat when the BSO cohort was compared with the endometriosis control cohort was 351 (95% CI, 272-591).CONCLUSION(S): In this nationwide study, we found that the (extra-)ovarian cancer incidence in women with histologically proven endometriosis decreased to less than the background population risk after BSO. Additionally, we found a significant reduction of the incidence of ovarian cancer when compared with women with histologically proven endometriosis without BSO. Endometriosis surgery could in the future be a preventive strategy in women with endometriosis and a high-risk profile for ovarian cancer.",

keywords = "Ovarian cancer, RISK, bilateral salpingo-oophorectomy, endometriosis, risk",

author = "Marjolein Hermens and {van Altena}, {Anne M} and Johan Bulten and {van Vliet}, {Huib A A M} and Siebers, {Albert G} and Bekkers, {Ruud L M}",

year = "2022",

month = may,

doi = "10.1016/j.fertnstert.2022.01.030",

language = "English",

volume = "117",

pages = "938--945",

journal = "Fertility and Sterility",

issn = "0015-0282",

publisher = "Elsevier Inc.",

number = "5",

}

TY - JOUR

T1 - Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis

AU - Hermens, Marjolein

AU - van Altena, Anne M

AU - Bulten, Johan

AU - van Vliet, Huib A A M

AU - Siebers, Albert G

AU - Bekkers, Ruud L M

PY - 2022/5

Y1 - 2022/5

N2 - OBJECTIVE: To assess the incidence of ovarian cancer in women with histologically proven endometriosis after bilateral salpingo-oophorectomy (BSO).DESIGN: Retrospective nationwide cohort study.SETTING: Dutch pathology database.PATIENT(S): Women with histologically proven endometriosis who had undergone BSO between 1990 and 2015 (n = 7,984). This study consists of 2 control cohorts: women with histologically proven endometriosis without BSO (n = 42,633) and women with a benign dermal nevus (n = 132,535).INTERVENTION(S): Observational study.MAIN OUTCOME MEASURE(S): Number of histologic diagnoses of (extra-)ovarian cancers. Incidence rate ratios (IRR) were estimated for (extra-)ovarian cancer. The number needed to treat was calculated.RESULT(S): We identified 9 (0.1%) (extra-)ovarian cancers in the BSO cohort and 170 (0.4%) and 444 (0.3%) ovarian cancers in the endometriosis and nevus control cohorts, respectively. We found an age-adjusted IRR of 0.34 (95% confidence interval [CI], 0.15-0.76) when the BSO cohort was compared with the endometriosis cohort. Comparing the BSO cohort with the nevus control cohort resulted in an age-adjusted IRR of 0.38 (95% CI, 0.17-0.85). The number needed to treat when the BSO cohort was compared with the endometriosis control cohort was 351 (95% CI, 272-591).CONCLUSION(S): In this nationwide study, we found that the (extra-)ovarian cancer incidence in women with histologically proven endometriosis decreased to less than the background population risk after BSO. Additionally, we found a significant reduction of the incidence of ovarian cancer when compared with women with histologically proven endometriosis without BSO. Endometriosis surgery could in the future be a preventive strategy in women with endometriosis and a high-risk profile for ovarian cancer.

AB - OBJECTIVE: To assess the incidence of ovarian cancer in women with histologically proven endometriosis after bilateral salpingo-oophorectomy (BSO).DESIGN: Retrospective nationwide cohort study.SETTING: Dutch pathology database.PATIENT(S): Women with histologically proven endometriosis who had undergone BSO between 1990 and 2015 (n = 7,984). This study consists of 2 control cohorts: women with histologically proven endometriosis without BSO (n = 42,633) and women with a benign dermal nevus (n = 132,535).INTERVENTION(S): Observational study.MAIN OUTCOME MEASURE(S): Number of histologic diagnoses of (extra-)ovarian cancers. Incidence rate ratios (IRR) were estimated for (extra-)ovarian cancer. The number needed to treat was calculated.RESULT(S): We identified 9 (0.1%) (extra-)ovarian cancers in the BSO cohort and 170 (0.4%) and 444 (0.3%) ovarian cancers in the endometriosis and nevus control cohorts, respectively. We found an age-adjusted IRR of 0.34 (95% confidence interval [CI], 0.15-0.76) when the BSO cohort was compared with the endometriosis cohort. Comparing the BSO cohort with the nevus control cohort resulted in an age-adjusted IRR of 0.38 (95% CI, 0.17-0.85). The number needed to treat when the BSO cohort was compared with the endometriosis control cohort was 351 (95% CI, 272-591).CONCLUSION(S): In this nationwide study, we found that the (extra-)ovarian cancer incidence in women with histologically proven endometriosis decreased to less than the background population risk after BSO. Additionally, we found a significant reduction of the incidence of ovarian cancer when compared with women with histologically proven endometriosis without BSO. Endometriosis surgery could in the future be a preventive strategy in women with endometriosis and a high-risk profile for ovarian cancer.

KW - Ovarian cancer

KW - RISK

KW - bilateral salpingo-oophorectomy

KW - endometriosis

KW - risk

U2 - 10.1016/j.fertnstert.2022.01.030

DO - 10.1016/j.fertnstert.2022.01.030

M3 - Article

C2 - 35300832

SN - 0015-0282

VL - 117

SP - 938

EP - 945

JO - Fertility and Sterility

JF - Fertility and Sterility

IS - 5

ER -

Incidence of ovarian cancer after bilateral salpingo-oophorectomy in women with histologically proven endometriosis

Abstract

Keywords

Access to Document

Fingerprint

Cite this