Hysterectomy and thyroid cancer risk: a systematic review and meta-analysis
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School of Specialization in Hygiene and Preventive Medicine, University of Perugia, Perugia, Italy
Department of Chemistry, Biology and Biotechnology, University of Perugia, Perugia, Italy
Department of Medicine and Surgery, University of Perugia, Perugia, Italy
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1531
Background: Incidence rates of thyroid cancer have increased considerably during the last two decades. Recent studies findings suggest that women who underwent a hysterectomy have an elevated relative risk of thyroid cancer. The aim of our review and meta-analysis is to summarize the evidence about the association between hysterectomy with or without oophorectomy and thyroid cancer risk. Methods: PubMed, Web of Science, and Scopus database were searched for studies published up to May 2022. The PRISMA statement and MOOSE guidelines were followed. Data derived from selected studies were pooled using a random effects model. Heterogeneity was explored with chi-square-based Cochran’s Q statistic and the I2 statistic. Publication bias was assessed with Begg’s and Egger’s tests. Results: Sixteen studies met the eligibility criteria. The pooled analysis showed a significantly 64% increment of thyroid cancer risk in association with any hysterectomy (OR 1.64, 95% CI 1.48–1.81; I2 = 28.68%, p = 0.156). Hysterectomy without oophorectomy was a stronger predictor of risk than hysterectomy with oophorectomy. The pooled analysis of data regarding hysterectomy without oophorectomy showed a statistically significant increment of thyroid cancer risk by 59% (OR 1.59, 95% CI 1.43–1.77; I2 = 31.32%, p = 0.178). Hysterectomy with oophorectomy was associated with an increase of thyroid cancer risk of 39% (OR 1.39, 95% CI 1.16–1.67; I2 = 42.10%, p = 0.049). Significant publication bias was not detected. Conclusions: Our findings might help with decision making around these surgeries. Additional research is needed to elucidate the biological mechanisms underlying this association.