PMID- 28796675
OWN - NLM
STAT- MEDLINE
DCOM- 20170908
LR  - 20180714
IS  - 1873-233X (Electronic)
IS  - 0029-7844 (Linking)
VI  - 130
IP  - 3
DP  - 2017 Sep
TI  - Long-term Follow-up After Endometrial Ablation in Finland: Cancer Risks and Later
      Hysterectomies.
PG  - 554-560
LID - 10.1097/AOG.0000000000002166 [doi]
AB  - OBJECTIVE: To study the risk of endometrial cancer and breast cancer and the
      hysterectomy rate after endometrial ablation. METHODS: In this retrospective
      cohort study, records of all women with endometrial ablation at ages 30-49 years 
      in Finland (1997-2014) were extracted from the Hospital Discharge Register and
      linked to the Cancer Registry and Finnish Central Population Register. The
      primary outcome was cancer incidences in the endometrial ablation cohort compared
      with those in the background population of the same age. Secondarily, the
      postablation hysterectomy rate was compared with that of a control cohort of
      similar-aged women extracted from the Finnish Central Population Register.
      Multivariate regression models with adjustment for age, parity, number of
      cesarean deliveries, history of sterilization, and the duration of follow-up were
      evaluated as risk factors for postablation hysterectomy. RESULTS: In total, 154
      cancers (standardized incidence ratio [observed-to-expected ratio] 0.96, 95% CI
      0.82-1.13) were diagnosed among 5,484 women treated with endometrial ablation
      during the follow-up of 39,892 women-years. The standardized incidence ratio for 
      endometrial cancer was 0.56 (95% CI 0.12-1.64) and for breast cancer 0.86 (95% CI
      0.67-1.09). A total of 1,086 (19.8%) women had postablation hysterectomy. Risk of
      hysterectomy was almost fourfold in the endometrial ablation cohort compared with
      26,938 women in a control group (adjusted hazard ratio [HR] 3.63, 95% CI
      3.32-3.96). Factors predisposing to postablation hysterectomy were leiomyomas
      (adjusted HR 1.78, 95% CI 1.03-3.10), age younger than 35 years (adjusted HR
      1.44, 95% CI 1.15-1.81), at least two prior cesarean deliveries (adjusted HR
      1.27, 95% CI 1.04-1.55), and history of sterilization (adjusted HR 1.15, 95% CI
      1.01-1.32). CONCLUSION: Endometrial ablation was not associated with an elevated 
      endometrial cancer or breast cancer risk in Finland. Leiomyomas, young age, and
      history of prior cesarean deliveries or sterilization were associated with an
      increased risk of postablation hysterectomy.
FAU - Soini, Tuuli
AU  - Soini T
AD  - Department of Obstetrics and Gynecology, Hyvinkaa Hospital, Hyvinkaa, the Finnish
      Cancer Registry, Institute for Statistical and Epidemiological Cancer Research,
      the Department of Obstetrics and Gynecology, Helsinki University Hospital, and
      the University of Helsinki, Helsinki, the Department of Obstetrics and
      Gynecology, Turku University Hospital, and the University of Turku, Turku, the
      Faculty of Medicine and Life Sciences, University of Tampere, the Department of
      Obstetrics and Gynecology, Tampere University Hospital, and the Faculty of Social
      Sciences, University of Tampere, Tampere, and the National Institute for Health
      and Welfare, Department of Information Services, Helsinki, Finland; and the
      Department of Neurobiology, Care Sciences and Society, Division of Family
      Medicine, Karolinska Institute, Stockholm, Sweden.
FAU - Rantanen, Matti
AU  - Rantanen M
FAU - Paavonen, Jorma
AU  - Paavonen J
FAU - Grenman, Seija
AU  - Grenman S
FAU - Maenpaa, Johanna
AU  - Maenpaa J
FAU - Pukkala, Eero
AU  - Pukkala E
FAU - Gissler, Mika
AU  - Gissler M
FAU - Hurskainen, Ritva
AU  - Hurskainen R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
SB  - AIM
SB  - IM
MH  - Adult
MH  - Cohort Studies
MH  - Endometrial Ablation Techniques/*adverse effects
MH  - Female
MH  - Finland/epidemiology
MH  - Humans
MH  - Hysterectomy/*statistics & numerical data
MH  - Middle Aged
MH  - Postoperative Complications/epidemiology/etiology
MH  - Registries
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Uterine Hemorrhage/*surgery
MH  - Uterine Neoplasms/*epidemiology/etiology
MH  - Women's Health Services
EDAT- 2017/08/11 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/08/11 06:00
PHST- 2017/08/11 06:00 [pubmed]
PHST- 2017/09/09 06:00 [medline]
PHST- 2017/08/11 06:00 [entrez]
AID - 10.1097/AOG.0000000000002166 [doi]
PST - ppublish
SO  - Obstet Gynecol. 2017 Sep;130(3):554-560. doi: 10.1097/AOG.0000000000002166.