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Long term effects of hysterectomy on mortality: nested cohort study

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.38483.669178.8F (Published 23 June 2005) Cite this as: BMJ 2005;330:1482
  1. Lisa Iversen, research fellow (l.iversen{at}abdn.ac.uk)1,
  2. Philip C Hannaford, professor of primary care1,
  3. Alison M Elliott, research fellow1,
  4. Amanda J Lee, reader in medical statistics1
  1. 1Department of General Practice and Primary Care, University of Aberdeen, Foresterhill Health Centre, Aberdeen AB25 2AY
  1. Correspondence to: L Iversen
  • Accepted 9 May 2005

Abstract

Objectives To investigate the long term risk (mean > 20 years) of death from all causes, cardiovascular disease, and cancer in women who had or had not had a hysterectomy.

Design Nested cohort study.

Setting Royal College of General Practitioners' oral contraception study.

Participants 7410 women (3705 flagged at the NHS central registries for cancer and death who had a hysterectomy during the oral contraception study and 3705 who were flagged but did not have the operation).

Main outcome measures Mortality from all causes, cardiovascular disease, and cancer.

Results 623 (8.4%) women had died by the end of follow-up (308 in the hysterectomy group and 315 in the non-hysterectomy group). Older women who had had a hysterectomy had a 6% reduced risk of death compared with women of a similar age who did not have the operation (adjusted hazard ratio 0.94, 95% confidence interval 0.75 to 1.18). Compared with young women who did not have a hysterectomy those who were younger at hysterectomy had an adjusted hazard ratio for all cause mortality of 0.82 (0.65 to 1.03). Hysterectomy was not associated with a significantly altered risk of mortality from cardiovascular disease or cancer regardless of age.

Conclusion Hysterectomy did not increase the risk of death in the medium to long term.

Footnotes

  • Contributors PCH had the original concept for the study and is also the guarantor. All authors designed the study and devised the data analysis plan. LI analysed the data and drafted the paper. AJL provided statistical advice. All authors commented on drafts and approved the final version of the paper. VA extracted the data from the oral contraception study's database.

  • Funding The oral contraception study has received support from the British Heart Foundation, Cancer Research UK, Medical Research Council, Royal College of General Practitioners, Organon Laboratories, Ortho Pharmaceutical, Schering AG, Schering Health Care, Syntex Pharmaceuticals, GD Searle, Syntex Pharmaceuticals, John Wyeth, and Brother.

  • Competing interests None declared.

  • Ethical approval The study was part of a masters degree submission and received approval from the ethics committee of the London School of Hygiene and Tropical Medicine.

  • Accepted 9 May 2005
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