Table 3.
Cohort studies examining association between bilateral salpingo-oophorectomy and all cause death
| Study | Cohort | Follow-up | Age group | Sample size | Deaths | Hazard ratio (95% CI) | Covariates | |
|---|---|---|---|---|---|---|---|---|
| Rocca 20063 | Mayo Clinic Cohort Study; prophylactic BSO v no ovarian surgery | Median 25.0 years | <45 | 1541 | 262 | 1.67 (1.16 to 2.40) | Age | |
| –HT | 1462 | 239 | 1.93 (1.25 to 2.39) | |||||
| +HT | 1496 | 252 | 1.27 (0.67 to 2.39) | |||||
| 45-50 | 888 | 315 | 1.02 (0.78 to 1.32) | |||||
| >50 | 491 | 235 | 0.90 (0.68 to 1.19) | |||||
| Parker 200915 | Nurses’ Health Study; BSO v ovarian conservation at non-malignant hysterectomy | Maximum 24 years | Overall | 29 380 | 3197 | 1.12 (1.03 to 1.21) | Age, parity, diabetes, hypertension, hypercholesterolemia, body mass index, smoking, alcohol intake, exercise, aspirin use, tubal ligation, oral contraceptive use, HT use, family history of breast cancer, family history of myocardial infarction <60 years | |
| <45 | NR | 1627 | 1.06 (0.95 to 1.80) | |||||
| 45-54 | NR | 1300 | 1.15 (1.01 to 1.32) | |||||
| ≥55 | NR | 270 | 1.14 (0.85 to 1.52) | |||||
| Parker 201316 | Nurses’ Health Study; BSO v ovarian conservation at non-malignant hysterectomy | Maximum 28 years | Overall | 30 117 | 4599 | 1.13 (1.06 to 1.21) | Age, parity, body mass index, smoking, alcohol intake, exercise, aspirin use, tubal ligation, oral contraceptive use, HT use, family history of breast cancer, family history of myocardial infarction <60 years | |
| <50 | 21 094 | 3433 | 1.13 (1.05 to 1.22) | |||||
| –HT | NR | 292 | 1.41 (1.04 to 1.92) | |||||
| +HT | NR | 1695 | 1.05 (0.94 to 1.17) | |||||
| 50-59 | 6241 | 883 | 1.10 (0.93 to 1.31) | |||||
| ≥60 | 2782 | 283 | 1.31 (0.98 to 1.75) | |||||
| Jacoby 201118 | Women’s Health Initiative; BSO v ovarian conservation at non-malignant hysterectomy | Mean 7.6 (SD 1.6) years | <40 | 7583 | 446 | 0.90 (0.72 to 1.13) | Age, parity, ethnicity, education, insurance, health care provider, hypercholesterolemia, hypertension, diabetes, body mass index, smoking, alcohol intake, exercise, myocardial infarction, stroke, coronary revascularisation, HT use, family history of myocardial infarction or stroke | |
| 40-49 | 11 397 | 661 | 1.00 (0.84 to 1.19) | |||||
| ≥50 | 2934 | 417 | 1.07 (0.84 to 1.35) | |||||
| Gierach 20144 | Breast Cancer Detection Demonstration Project; BSO v no gynaecological surgery | Mean 22.1 years | ≤35 | 50 742 | 13 237 | 1.20 (1.08 to 1.34) | Landmark analyses at differing ages: adjusted for body mass index, alcohol intake, smoking, HT use, birth cohort | |
| ≤45 | 44 971 | 11 894 | 1.10 (1.03 to 1.17) | |||||
| ≤55 | 42 053 | 10 862 | 1.01 (0.96 to 1.06) | |||||
| Mytton 20175 | English Hospital Episode Statistics; BSO v ovarian conservation at non-malignant hysterectomy | Mean 6.2 (SD 2.8) years | 35-45 | 113 679 | 832 | 1.56 (1.37 to 1.81)* | Age, deprivation, surgery type, Charlson comorbidity score, number of admissions before hysterectomy | |
| Wilson 20196 | Australian Longitudinal Study; hysterectomy with BSO v no gynaecological surgery | Median 21.5 years | <50 | 11 069 | 734 | 1.02 (0.78 to 1.34) | Age, body mass index, smoking, alcohol intake, exercise, education, difficulty managing on income, remoteness category, number of children, diabetes, hypertension, perception of general health | |
| –HT | 8354 | 518 | 1.81 (1.01 to 3.25) | |||||
| +HT | 2708 | 216 | 0.91 (0.67 to 1.24) | |||||
| Tuesley 20207 | Western Australia electoral roll; hysterectomy with BSO v no gynaecological surgery | Median 24.2 years | Overall | 666 588 | 33 963 | 0.94 (0.88 to 1.00) | Age at entry, area of residence, area level socioeconomic status, parity (time varying), tubal ligation (time varying) | |
| <35 | 1013 | 59 | 1.44 (1.12 to 1.87) | |||||
| 35-44 | 4936 | 291 | 1.15 (1.02 to 1.29) | |||||
| 45-54 | 8599 | 414 | 0.82 (0.74 to 0.90) | |||||
| 55-64 | 2963 | 241 | 0.90 (0.79 to 1.02) | |||||
| ≥65 | 1046 | 96 | 0.90 (0.74 to 1.10) | |||||
| Cusimano 2021 | ICES Ontario Databases; BSO v ovarian conservation at non-malignant hysterectomy | Median 12.0 years | <45 | 96 462 | 2268 | 1.31 (1.18 to 1.45) | Age, year of surgery, rural or urban residence, area level income fifth, ethnicity, immigration status, hysterectomy type, abnormal uterine bleeding, fibroids, ovarian cysts, endometriosis, pelvic pain or inflammation, premalignant disease, prolapse, overall comorbidity score, chronic obstructive pulmonary disease, hypertension, diabetes, previous malignancy, cardiovascular disease, previous ovarian surgery, previous abdominopelvic surgery | |
| 45-49 | 55 425 | 1516 | 1.16 (1.04 to 1.30) | |||||
| 50-54 | 27 213 | 982 | 0.83 (0.72 to 0.97) | |||||
| ≥55 | 21 449 | 2267 | 0.92 (0.82 to 1.03) | |||||
BSO=bilateral salpingo-oophorectomy; HT=hormone therapy; NR=not reported; SD=standard deviation.
*
Mytton and colleagues reported BSO as the reference group (0.64, 95% confidence interval 0.55-0.73); to facilitate comparison, we present the reciprocal.