Does hysterectomy for benign indications decrease the risk of ovarian cancer? A national population-based study

Abstract This study aimed to assess the impact of hysterectomy for benign gynecologic conditions on ovarian cancer incidence and all-cause mortality among women diagnosed with ovarian cancer. Using Korean health insurance data (2007–2020), a retrospective cohort study focused on women aged 40 to 59 years undergoing hysterectomy (with or without adnexal surgery) between 2011 and 2014. The control group included same-aged women receiving health exams during the same period. After 1:1 propensity matching, the incidence of ovarian cancer and all-cause mortality were compared. Out of 133,288 women undergoing medical exams and 70,787 undergoing hysterectomy, 70,787 controls were matched. Median ages for control and hysterectomy groups were 46 and 47 years, respectively. Ovarian cancer incidence was 0.1% (92/70,695) in controls and 0.2% (111/70,676) in the hysterectomy group (P = 0.182). Stratified multivariate analysis found no significant difference in ovarian cancer risk between groups (adjusted hazard ratio 1.213, 95% CI 0.902–1.63). In ovarian cancer patient subgroups, all-cause mortality didn't significantly differ between hysterectomy and control groups (adjusted HR 0.932, 95% CI 0.363–2.393). In conclusion, hysterectomy with or without adnexal surgery didn't impact ovarian cancer incidence or overall survival.