Table 1.
Characteristics of studies on hysterectomy in association with thyroid cancer risk.
| Author, year Location |
Study design, Study name |
Study population Subjects Cases/controls Follow-up Age Reason of surgery |
Hysterectomy/ Oophorectomy (Assessment) |
Age at surgery | OR/RR/HR/SIR (95% CI) |
Matched or adjusted variables | QSa |
|---|---|---|---|---|---|---|---|
| Jin et al., 2021 Korea [20] |
Prospective cohort Korean Genome and Epidemiology Study |
Population: 107,365 Hysterectomy: 11,295 Cases: 1303 Follow-up: 12 y Age ≥ 40 y |
No surgery Any hysterectomy (Self-reported) |
Ref. 1.00 1.73 (1.48–2.01) |
Age, BMIb, hypertension, diabetes mellitus, thyroid disease histories, occupation, smoking, alcohol, oophorectomy, number of children, use of oral contraceptive |
9 | |
| Wilson et al., 2021 Australia [21] |
Population-based retrospective cohort | Population: 838,237 Hysterectomy: 74,056 Cases: 2003 Follow-up: 27 y Age at entry: 29.9–39.6 y Benign indication |
No surgery Hysterectomy without oopherectomy (Hospital record) Hysterectomy-USO4 Hysterectomy-BSO5 |
<45 y 45–54 y >55 y <45 y 45–54 y >55 y |
Ref. 1.00 1.38 (1.19–1.60) 1.38 (1.18–2.53) 1.46 (1.16–1.83) 0.87 (0.48–1.56) 0.84 (0.44–1.64) 1.18 (0.90–1.54) 1.19 (0.78–1.80) 1.11 (0.76–1.63) 1.31 (0.73–2.35) |
Age, parity, remoteness category, SEIFAc quintile, fibroids, endometriosis, prolapse | 9 |
| Rahman et al., 2021 Australia [22] |
Population-based case-control Queensland Thyroid Cancer Study (QTCS) |
Cases: 685 Hysterectomy: 159 Age: 51 (40–60) y Control: 785 Hysterectomy: 126 Age: 52 (41–62) y Bleeding disorders, prolapse, cancer or other reason |
No surgery Any hysterectomy Hysterectomy without oopherectomy (Self-reported) Hysterectomy-BSO |
<55 y ≥55 y <55 y ≥55 y |
Ref. 1.00 1.45 (1.07–1.96) 1.55 (1.08–2.23) 1.60 (1.11–2.33) 0.80 (0.19–3.44) 1.31 (0.86–1.98) 1.45 (0.92–2.30) 0.88 (0.38–2.02) |
Age, educational attainment, IRSDd score, BMI, endometriosis, fibroids, PCOSe | 7 |
| Kim et al., 2021 Korea [23] |
Nationwide cohort | Population: 671,291 Hysterectomy: 78,961 Follow-up: 12.7 y Incident cases: 12,959 Age: 40.9 ± 10.8 |
No surgery Hysterectomy without oopherectomy (Hospital record) |
<50 y ≥50 y |
Ref. 1.00 1.68 (1.58–1.79) 1.66 (1.55–1.78) 1.28 (1.10–1.49) |
Age, BMI, smoking, alcohol, indication for surgery, frequency of hospital visit, co-morbidities, history of malignancy, hormone therapy, thyroid disease | 9 |
| Guenego et al., 2019 France [24] |
Cohort Etude Epidemiologi-que de Femmes de la Mutuelle Générale de l'Education Nationale (E3N) |
Population: 89,340 Hysterectomy: 16,064 Incident cases: 412 Follow-up: 9.9 y for cases 21.4 y for non-cases Age hysterectomy: 53.1 ± 6.2 y Age no hysterectomy: 48.8 ± 6.5 y Benign indication |
No surgery Any hysterectomy Hysterectomy without oopherectomy (Self-reported) Hysterectomy-BSO |
≤40 y 40–45 y >45 y |
Ref. 1.00 2.15 (1.72–2.69) 1.96 (1.46–2.65) 2.69 (1.78–4.08) 1.97 (1.32–2.93) 2.08 (1.57–2.74) 2.35 (1.77–3.11) |
Age, smoking, dysthyroidism, benign thyroid disease, BMI, age at menarche, use of oral contraceptives, infertility treatment, parity and age at first full-term pregnancy, age at menopause and use of MHTf | 7 |
| Falconer et al., 2017 Sweden [25]i |
Nationwide, Population-based cohort | Population: 5,379,882 Hysterectomy: 90,235 Age: 51.1 ± 11.09 No hysterectomy: 5,379,843 Age: 42.4 ± 21.86 y Follow-up: 37 y Incident cases: 2934 Benign indication |
No surgery Any hysterectomy (Hospital record) |
Ref. 1.00 1.76 (1.45–2.14) |
Age at surgery, educational level and parity | 9 | |
| Luo et al. 2016 USA [26] |
Cohort Women's Health Initiative (WHI) |
Population: 127,566 Hysterectomy: 46,852 Age: 50–79 y Follow-up: 14,4 y Incident cases: 344 |
No surgery Any hysterectomy Hysterectomy without oopherectomy (Self-reported) Hysterectomy-BSO |
<40 y 40–50 y >50 y |
Ref. 1.00 1.46 (1.16–1.85) 1.45 (1.08–1.94) 1.57 (1.13–2.17) 1.50 (1.12–1.99) 1.27 (0.86–1.88) 1.48 (1.13–1.93) |
Age, education, smoking, BMI, physical activity, alcohol, thyroid disease | 7 |
| Altman et al., 2016 Sweden [27] |
Population-based cohort | Population: 5,379,882 Hysterectomy: 111,595 Incident cases: 119 Follow-up: 14,4 Benign indication |
No surgery Any hysterectomy Hysterectomy-BSO (Hospital record) |
Ref. 1.00 1.76 (1.45–2.14) 1.11 (0.66–1.88) |
Age, calendar year, parity, education | 9 | |
| Braganza et al., 2014 USA [28] |
Cohort Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial |
Population: 70,047 Hysterectomy: not reported Age: 50–78 y, median 62y Follow-up: 11 y Incident cases: 127 |
No surgery Any hysterectomy Hysterectomy-BSO (Self-reported) |
Ref. 1.00 1.22 (0.80–1.86) 1.21 (0.71–2.06) |
Age, education, race, marital status, family history of thyroid cancer, baseline body mass index, smoking status | 9 | |
| Kabat et al., 2012 USA [29] |
Cohort Women's Health Initiative (WHI) |
Population: 145,007 Hysterectomy: not reported Follow-up: 12.7 y Incident cases: 296 |
No surgery Any hysterectomy (Self-reported) |
Ref. 1.00 1.28 (0.99–1.67) |
Age, education, height history of goiter/nodules, smoking, alcohol | 7 | |
| Wong et al., 2006 China [30] |
Nested case-cohort | Population: 267,400 Subcohort non-cases: 3187 Hysterectomy: 130 Follow-up: 10 y Incident cases:130 |
No surgery Any hysterectomy (Self-reported) |
Ref. 1.00 0.94 (0.29–3.05) |
Age at first live delivery, number of live births, age at first live delivery | 7 | |
| Truong et al., 2005 New Caledonia [31] |
Population-based case-control | Cases: 293 Controls: 354 |
No surgery Any hysterectomy Hysterectomy without oopherectomy (Self-reported) Hysterectomy-USO Hysterectomy-BSO |
<43 43–48 ≥49 |
Ref. 1.00 1.5 (0.8–2.8) 1.5 (0.7–3.3) 1.8 (0.7–4.8) 1.3 (0.4–3.9) 0.9 (0.3–3.2) 1.6 (0.3–8.7) 1.5 (0.5–4.5) |
Age, ethnic group | 7 |
| Luoto et al., 2003 Finland [32] |
Population-based cohort | 93,282 Hysterectomy: 58,721 Follow up: 6 y Incident cases: 118 |
No surgery Any hysterectomy Hysterectomy-USO Hysterectomy-BSO (Hospital record) |
Ref. 1.00 1.52 (1.15–1.96) 0.89 (0.36–1.82) 1.41 (0.96–2.00) |
None | 7 | |
| Rossing et al., 2000 USA [33] |
Population-based case-control | Cases: 410 Controls: 574 Hysterectomy: 214 Age: 45–64 Fibroids, dysmenorrhea endometriosis, cervical cancer, prolapsed uterus/other uterine problem |
No surgery Any hysterectomy Hysterectomy without oopherectomy (Self-reported) Hysterectomy-BSO |
≤30 31–40 >41 |
Ref. 1.00 1.8 (1.1–3.0) 2.2 (1.3–4.0) 1.8 (0.7–4.9) 2.0 (1.1–3.9) 1.6 (0.8–3.2) 1.3 (0.6–2.6) |
Age, county | 8 |
| Mack et al., 1999 USA [34] |
Individually neighbourhood matched case-control | Cases: 292 Controls: 292 Hysterectomy: 62 Age: 15–54 y |
No surgery Any hysterectomy Hysterectomy without oopherectomy (Self-reported) Hysterectomy-USO Hysterectomy-BSO |
Ref. 1.00 1.9 (1.0–3.8) 1.0 (0.4–2.4) 2.2 (0.5–9.3) 6.5 (1.1–38.1) |
Age, study period | 8 | |
| Luoto et al., 1997 Finland [35] |
Retrospective cohort | Hysterectomy: 25,382 Follow-up: 20.5 y No hysterectomy: ∼25,382 Follow-up: 19.9 y Incident cases: 71 |
No surgery Any hysterectomy (Self-reported) |
Ref. 1.00 2.1 (1.5–3.1) |
Age, education, parity, and follow-up | 7 |
a
Quality Score; bBody Mass Index; cSocio-Economic Indexes for Areas; d Index of Relative Socioeconomic Disadvantage; ePolycystic Ovarian Syndrome; fMenopausal Hormone Therapy; gExcluded from meta-analysis because included in Altman et al. [27]