Elective Bilateral Salpingo-Oophorectomy Has Decreased

Rate of elective procedure fell from 2002 to 2006 after increasing from 1998 to 2001
By Jeff Muise
HealthDay Reporter

MONDAY, Oct. 25 (HealthDay News) -- The proportion of women electing to undergo bilateral salpingo-oophorectomy has dropped significantly since 2002 after increasing in prior years, though the risks versus the benefits have not been clearly established, according to a study in the November issue of Obstetrics & Gynecology.

Albert Asante, M.D., of the Emory University School of Medicine in Atlanta, and colleagues assembled data on 2,250,041 women (aged 15 or older) at average risk for ovarian cancer who underwent hysterectomy for a benign gynecologic condition. The researchers assessed and compared trends for elective bilateral salpingo-oophorectomy rates for the time periods of 1998 to 2001 and 2002 to 2006 and assessed the risk of complications associated with the procedure.

The rate for elective salpingo-oophorectomy increased significantly from 7.8 per 10,000 in 1998 to 9.0 per 10,000 in 2001, then decreased significantly from 9.0 per 10,000 in 2002 to 7.4 per 10,000 in 2006, with the largest decrease in women aged 45 to 49 years. Compared with hysterectomy only, the researchers found that elective bilateral salpingo-oophorectomy was associated with an increased risk of complications when performed vaginally (odds ratio [OR], 1.12) and a decreased risk when performed abdominally (OR, 0.91) or laparoscopically (OR, 0.89).

"It is interesting to note that the elective bilateral salpingo-oophorectomy rate decreased significantly since 2002, the same year that the Women's Health Initiative early-termination results were published. Although the Women's Health Initiative did not address estrogen replacement therapy in younger women undergoing bilateral salpingo-oophorectomy, it may have resulted in gynecologists and patients becoming increasingly reluctant toward elective bilateral salpingo-oophorectomy as a result of concerns about the safety of estrogen therapy," the authors write.

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