Ovary Removal Raises Risk Of Death, Study Finds

April 21, 2009|By Deborah L. Shelton | Deborah L. Shelton,Tribune Newspapers

Women who have healthy ovaries removed when they have a hysterectomy face a higher risk of death, including from coronary heart disease and lung cancer, than those who keep their ovaries, new research shows.

The finding, from a study published in the May issue of the journal Obstetrics & Gynecology, challenges conventional wisdom that removing ovaries along with the uterus offers the best chance for long-term survival.

Doctors have recommended for decades that women who get a hysterectomy consider having both ovaries removed - a surgical procedure called a bilateral oophorectomy - to prevent ovarian cancer later in life.

Ovarian cancer is rare, accounting for about 3 percent of all cancers and 1 percent of cancer deaths in women. But it is difficult to detect and treat, so many women opt to have their ovaries taken out.

Of the 600,000 women who get a hysterectomy in the United States each year, about 300,000 also have their ovaries removed - about 50 percent of those between the ages 40 and 44 and 78 percent of those between the ages of 45 and 64.

But the study authors said routine removal is often not a good choice. Though the risk of ovarian and breast cancer declined after ovary removal, women's risk of heart disease and stroke nearly doubled, and risk of death overall rose by 40 percent.

"For the last 35 years, most doctors have been routinely advising women undergoing hysterectomy to have their ovaries removed to prevent ovarian cancer," said lead author Dr. William H. Parker, who is on the adjunct faculty at the John Wayne Cancer Institute at St. John's Health Center in Santa Monica, Calif. "We believe that such an automatic recommendation is no longer warranted."

Removing the ovaries did not appear to provide an overall survival benefit for any age group of women, in large part because heart disease, stroke and lung cancer are all far more common than ovarian cancer.

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