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Increased risk of thyroid cancer among women with hysterectomies

      Abstract

      Objective: Hysterectomy with bilateral oophorectomy has been suggested to increase the risk of thyroid cancer. We studied the relationship between hysterectomy and thyroid cancer in a population-based setting in Finland. Study Design: Women undergoing hysterectomy between 1986 and 1995 (n = 17,900) were identified from the National Hospital Discharge Registry. The cohort was followed up through the Finnish Cancer Registry until 1997. Results: There were 118 cases of thyroid cancer diagnosed, 103 papillary and 15 follicular or medullar type. The incidence for thyroid cancer was significantly elevated (standardized incidence ratio [SIR] 1.38, 95% CI 1.15-1.64). The increase in the incidence of thyroid cancer was not dependent on the extent of operation but on the length of follow-up. Thyroid cancer incidence was increased 0.5 to 1.4 years after hysterectomy (SIR 2.00, 95% CI 1.31-2.93), but decreased thereafter (SIR 1.30, 95% CI 0.99-1.67). Hysterectomy with and without oophorectomy was associated with a similar increase in the incidence of thyroid cancer. Conclusion: Women who have undergone hysterectomy have an increased risk of thyroid cancer during the first 2 years after the operation. Thyroid cancer and bleeding disorders may share a common background. (Am J Obstet Gynecol 2003;188:45-8.)

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      References

        • Luoto R
        • Kaprio J
        • Keskimäki I
        • Pohjanlahti J-P
        • Rutanen E-M.
        Hysterectomy in Finland 1987-1989—incidence, indications and surgical approaches.
        Int J Epidemiol. 1994; 23: 348-358
        • Settnes A
        • Jorgensen T.
        Hysterectomy in a Danish cohort: Prevalence, incidence and socio-demographic characteristics.
        Acta Obstet Gynecol Scand. 1996; 75: 274-280
        • Vuorma S
        • Teperi J
        • Hurskainen R
        • Keskimäki I
        • Kujansuu E.
        Hysterectomy trends in Finland in 1987-1995—a register based analysis.
        Acta Obstet Gynecol Scand. 1998; 77: 770-776
        • Krassas GE.
        Thyroid disease and female reproduction.
        Fertil Steril. 2000; 74: 1063-1070
        • McTiernan AM
        • Weiss NS
        • Daling JR.
        Incidence of thyroid cancer in women in relation to reproductive and hormonal factors.
        Am J Epidemiol. 1984; 120: 423-435
        • Preston-Martin S
        • Bernstein L
        • Maldonado AS
        • Henderson BE.
        Thyroid cancer among young women related to prior thyroid disease and pregnancy history.
        Br J Cancer. 1987; 55: 191-195
        • Ron E
        • Kleinerman R
        • Boice JE
        • Livolsi VA
        • Flannery JT.
        A population-based case-control study of thyroid cancer.
        J Natl Cancer Inst. 1987; 79: 1-12
        • Franceschi S
        • Fassina A
        • Talamini R
        • Mazzolini A
        • Vianello S
        • Bidoli E
        • et al.
        Risk factors for thyroid cancer in North Italy.
        Int J Epidemiol. 1989; 18: 578-584
        • Kolonel LH
        • Hankin JH
        • Wilkins LR
        • Fukunaga FH
        • Hinds MW.
        An epidemiologic study of thyroid cancer in Hawaii.
        Cancer Causes Control. 1990; 1: 223-234
        • Levi F
        • Franceschi S
        • Gulie C
        • Negri E
        • La Vecchia C.
        Female thyroid cancer: The role of reproductive and hormonal factors in Switzerland.
        Oncology. 1993; 50: 309-315
        • Luoto R
        • Auvinen A
        • Pukkala E
        • Hakama M.
        Hysterectomy and subsequent risk of cancer.
        Int J Epidemiol. 1997; 26: 476-483
        • Keskimäki I
        • Aro S.
        Accuracy of data on diagnoses, procedures and accidents in the Finnish hospital discharge register.
        Int J Health Sci. 1991; 2: 15-21
        • Pukkala E.
        Use of record linkage in small-area studies.
        in: Geographical and environmental epidemiology. Oxford University Press, Oxford1992: 125-131
        • Fraser IS.
        Menorrhagia—a pragmatic approach to the understanding of causes and the need for investigations.
        Br J Obstet Gynaecol. 1994; 101: 3-7
        • Higham JM
        • Shaw RW.
        The effect of thyroxine replacement on menstrual blood loss in a hypothyroid patient.
        Br J Obstet Gynaecol. 1992; 99: 695-696
        • Hegedus LS
        • Karstrup S
        • Rasmussen N.
        Evidence of cyclic alterations of thyroid size during the menstrual cycle in healthy women.
        Am J Obstet Gynecol. 1986; 155: 142-145
        • Wilansky DL
        • Greisman B.
        Early hypothyroidism in patients with menorrhagia.
        Am J Obstet Gynecol. 1989; 160: 673-677
        • Krassas GE
        • Pontikides N
        • Kaltsas TH
        • Papadopoulou PH
        • Paunkovic J
        • Paukovic N
        • et al.
        Disturbances of menstruation in hypothyroidism.
        Clin Endocrinol. 1999; 50: 655-659
        • Cappello F
        • Barbato F
        • Tomasino RM.
        Mature teratoma of the uterine corpus with thyroid differentiation.
        Pathol Int. 2000; 50: 546-548
        • Phillips DI
        • Lazarus JH
        • Butland BK.
        The influence of pregnancy and reproductive span on the occurrence of autoimmune thyroiditis.
        Clin Endocrinol. 1990; 32: 301-306
        • Biro J
        • Ritzen EM
        • Hall K
        • Eneroth P.
        Effects of hysterectomy and uterine extracts on growth hormone, somatomedin, prolactin, thyrotrophin and thyroid hormones in adult rats.
        Acta Endocrinol. 1983; 103: 172-179
      1. Cancer Incidence in Finland. Finnish Cancer Registry.
        (Available from) (Accessed)
        • Franceschi S
        • Preston-Martin S
        • Dal Maso L
        • Negri E
        • LaVecchia C
        • Mack WJ
        • et al.
        A pooled analysis of case-control studies of thyroid cancer, IV: Benign thyroid diseases.
        Cancer Causes Control. 1999; 10: 583-595
        • Dickman PW
        • Hakulinen T
        • Luostarinen T
        • Pukkala E
        • Sankila R
        • Söderman B
        • et al.
        Survival of cancer patients in Finland 1955-1994.
        Acta Oncol. 1999; 38: 1-103
        • Luoto R
        • Hemminki E
        • Topo P
        • Uutela A
        • Kangas I.
        Hysterectomy among Finnish women—prevalence and women's own opinions.
        Scand J Soc Med. 1992; 20: 209-212