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Bilateral oophorectomy and rate of colorectal cancer: A prospective cohort study

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Worldwide, colorectal cancer is the second most common cancer and third cause of cancer death in women. Estrogen exposure has been inversely associated with colorectal cancer. Oophorectomy reduces circulating estrogen, but the effect on colorectal cancer remains uncertain. The aim of this study was to examine the association between unilateral and bilateral oophorectomy and subsequent risk of colorectal cancer, and whether this association varied by menopausal status at time of oophorectomy, use of hormone replacement therapy (HRT) at baseline, hysterectomy and baseline body mass index (BMI). The study included 25 698 female nurses (aged ≥45 years) participating in the Danish Nurse Cohort. Nurses were followed from baseline until date of colorectal cancer, death, emigration or end of follow-up at December 31, 2018, whichever came first. We examined the association between oophorectomy and colorectal cancer (all ages and stratified by menopausal status). The potential modifying effects of hysterectomy, HRT use at baseline and BMI were investigated. During 542 140 person-years of follow-up, 863 (3.4%) nurses were diagnosed with colorectal cancer. Bilateral oophorectomy was associated with a 79% increased colorectal cancer rate, adjusted rate ratio (aRR) (95% confidence interval [CI]): 1.79 (1.33-2.42). Effect estimates following unilateral oophorectomy also showed higher rate of colorectal cancer, although less pronounced and nonstatistically significant (aRR) (95% CI): 1.25 (0.86-1.82). Similar results were seen when stratifying by menopausal status. The association was not modified by baseline HRT use, hysterectomy or BMI. Oophorectomy was associated with increased rate of colorectal cancer, with highest rates among women with bilateral oophorectomy.

Original languageEnglish
Article number33776
JournalInternational Journal of Cancer
Issue number1
Pages (from-to)38-46
Number of pages9
Publication statusPublished - 1 Jan 2022

Bibliographical note

Funding Information:
The Health Foundation of Denmark (Helsefonden, Grant no. 19‐B‐0077). The funding covered salary for Trine Koch and Elvira V. Bräuner. Martha Hickey is supported by a NHMRC Investigator Grant (ID number 1193838). The funding bodies had no direct role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; or the decision to submit the manuscript for publication. Funding information:

Funding Information:
NHMRC Investigator Grant, Grant/Award Number: 1193838; Helsefonden, Grant/Award Number: 19‐B‐0077 Funding information

Publisher Copyright:
© 2021 UICC.

    Research areas

  • colorectal cancer, hormone therapy, hysterectomy, oophorectomy, rate, Body Mass Index, Prognosis, Prospective Studies, Follow-Up Studies, Hysterectomy/adverse effects, Humans, Middle Aged, Risk Factors, Hormone Replacement Therapy/adverse effects, Colorectal Neoplasms/drug therapy, Aged, 80 and over, Female, Aged, Ovariectomy/adverse effects

ID: 69752052