Abstract：
OBJECTIVE: Hysterectomy is commonly performed for benign uterine pathologies but there is some controversy over whether it is associated with an increased risk of thyroid cancer. This study examines the associations of hysterectomy with ovarian conservation or with bilateral salpingo-oophorectomy and thyroid cancer incidence in Taiwan.
METHODS: We analyzed data from a nationwide health insurance claims database and identified 29,577 women aged ≥30 years who underwent hysterectomy with ovarian conservation or hysterectomy with bilateral salpingo-oophorectomy between 2000 and 2016. Propensity score-matching analyses were performed at ratios of 1:1 for the hysterectomy and no-hysterectomy groups, to reduce selection bias. We monitored thyroid cancer occurrence in both groups until 2017. Cox regression was used to calculate hazard ratios with 95 % confidence intervals and determine thyroid cancer risk in women who underwent hysterectomy.
RESULTS: The study comprised 29,577 patients who underwent any hysterectomy and 29,577 participants who did not. The mean follow-up period was 10.03 ± 4.92 years. Patients who underwent hysterectomy had higher thyroid cancer incidence (4.72 per 10,000 person-years) than those who did not (3.06 per 10,000 person-years) and a greater risk of any thyroid cancer (adjusted hazard ratio = 1.40; 95 % confidence interval = 1.08-1.82). However, there was no association between hysterectomy with bilateral salpingo-oophorectomy and thyroid cancer incidence (p > 0.05).
CONCLUSIONS: Our findings suggest that women who undergo hysterectomy are at a higher risk of developing thyroid cancer than those who do not.
METHODS: We analyzed data from a nationwide health insurance claims database and identified 29,577 women aged ≥30 years who underwent hysterectomy with ovarian conservation or hysterectomy with bilateral salpingo-oophorectomy between 2000 and 2016. Propensity score-matching analyses were performed at ratios of 1:1 for the hysterectomy and no-hysterectomy groups, to reduce selection bias. We monitored thyroid cancer occurrence in both groups until 2017. Cox regression was used to calculate hazard ratios with 95 % confidence intervals and determine thyroid cancer risk in women who underwent hysterectomy.
RESULTS: The study comprised 29,577 patients who underwent any hysterectomy and 29,577 participants who did not. The mean follow-up period was 10.03 ± 4.92 years. Patients who underwent hysterectomy had higher thyroid cancer incidence (4.72 per 10,000 person-years) than those who did not (3.06 per 10,000 person-years) and a greater risk of any thyroid cancer (adjusted hazard ratio = 1.40; 95 % confidence interval = 1.08-1.82). However, there was no association between hysterectomy with bilateral salpingo-oophorectomy and thyroid cancer incidence (p > 0.05).
CONCLUSIONS: Our findings suggest that women who undergo hysterectomy are at a higher risk of developing thyroid cancer than those who do not.
摘要：
目的：子宫切除术通常用于良性子宫病变，但在其是否与甲状腺癌风险增加相关方面存在一些争议。这项研究探讨了台湾子宫切除术与卵巢保留或双侧输卵管卵巢切除术和甲状腺癌发病率的关系。
方法：我们分析了来自全国健康保险索赔数据库的数据，并确定了2000年至2016年期间29,577名年龄≥30岁的女性接受了子宫切除术伴卵巢保留或子宫切除术伴双侧附件卵巢切除术。子宫切除术组和非子宫切除术组以1:1的比例进行倾向评分匹配分析，以减少选择偏差。我们监测了两组的甲状腺癌发生率，直至2017年。Cox回归用于计算95%置信区间的风险比，并确定接受子宫切除术的女性患甲状腺癌的风险。
结果：该研究包括29,577例接受子宫切除术的患者和29,577例未接受子宫切除术的参与者。平均随访时间为10.03±4.92年。接受子宫切除术的患者甲状腺癌发病率（4.72/10,000人年）高于未接受子宫切除术的患者（3.06/10,000人年），并且患甲状腺癌的风险更高（调整后的风险比=1.40；95％置信区间=1.08-1.82）。然而,子宫切除和双侧附件切除与甲状腺癌发生率无相关性(p>0.05).
结论：我们的研究结果表明，接受子宫切除术的妇女患甲状腺癌的风险高于不接受子宫切除术的妇女。
方法：我们分析了来自全国健康保险索赔数据库的数据，并确定了2000年至2016年期间29,577名年龄≥30岁的女性接受了子宫切除术伴卵巢保留或子宫切除术伴双侧附件卵巢切除术。子宫切除术组和非子宫切除术组以1:1的比例进行倾向评分匹配分析，以减少选择偏差。我们监测了两组的甲状腺癌发生率，直至2017年。Cox回归用于计算95%置信区间的风险比，并确定接受子宫切除术的女性患甲状腺癌的风险。
结果：该研究包括29,577例接受子宫切除术的患者和29,577例未接受子宫切除术的参与者。平均随访时间为10.03±4.92年。接受子宫切除术的患者甲状腺癌发病率（4.72/10,000人年）高于未接受子宫切除术的患者（3.06/10,000人年），并且患甲状腺癌的风险更高（调整后的风险比=1.40；95％置信区间=1.08-1.82）。然而,子宫切除和双侧附件切除与甲状腺癌发生率无相关性(p>0.05).
结论：我们的研究结果表明，接受子宫切除术的妇女患甲状腺癌的风险高于不接受子宫切除术的妇女。
