Abstract A72: Bilateral oophorectomy and cancer mortality in African American women.

Abstract

Abstract Hysterectomy is one of the most common surgical procedures in the U.S., and many women also undergo bilateral oophorectomy at the time of hysterectomy. African American women are more likely than white women to undergo gynecologic surgery, particularly at younger ages. The effect of premature loss of ovarian hormones on long-term health is not well understood. Based on limited epidemiologic data, bilateral oophorectomy has been associated with a reduced risk of breast cancer but an increased risk of colorectal cancer, lung cancer, and total cancer mortality. The objective of the present study was to investigate the relation of bilateral oophorectomy to cancer mortality among African American women. We used data from the Black Women's Health Study, a follow-up of women aged 21-69 years at enrollment in 1995. The analysis was restricted to 11,745 women who had had a hysterectomy, either with bilateral oophorectomy (47%) or with retention of both ovaries (53%). Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for cancer mortality in relation to bilateral oophorectomy compared with hysterectomy alone. Multivariable models were adjusted for age, age at surgery, female hormone use, and other lifestyle factors. During 14 years of follow-up from 1995 to 2009, 241 cancer deaths occurred in the study group. The multivariable HRs were 1.05 (95% CI 0.79-1.39) for bilateral oophorectomy overall, 1.05 (95% CI 0.77-1.44) for bilateral oophorectomy at age <45 years, and 1.18 (95% CI 0.76-1.83) for bilateral oophorectomy among nonusers of female hormones. For breast cancer mortality, the HRs were 0.70 (95% CI 0.33-1.49) for all bilateral oophorectomies, 0.57 (95% CI 0.23-1.42) for bilateral oophorectomy before age 45, and 0.58 (95% CI 0.14-2.52) among nonusers of female hormones. The corresponding HRs for mortality from other (non-reproductive) cancers were 1.19 (95% CI 0.87-1.63), 1.23 (95% CI 0.88-1.73), and 1.34 (95% CI 0.83-2.17), respectively. Our results suggest that women who undergo surgical removal of their ovaries and do not take female hormone supplements may have a reduction in mortality from breast cancer but an increased mortality from other cancers. Further work is needed to establish the magnitude of these risks and benefits. Citation Format: Deborah A. Boggs, Julie R. Palmer, Lynn Rosenberg. Bilateral oophorectomy and cancer mortality in African American women. [abstract]. In: Proceedings of the Fifth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2012 Oct 27-30; San Diego, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2012;21(10 Suppl):Abstract nr A72.