MedicalResearch.com Interview with:
Josefin Segelman MD, PhD
Senior consultant colorectal surgeon
Department of Molecular Medicine and Surgery
MedicalResearch.com: What is the background for this study?
Dr. Segelman: Hormonal factors influence the development of colorectal cancer. Observational studies and clinical trials have reported a protective effect of hormone replacement therapy and oral contraceptives. Oophorectomy alters endogenous levels of sex hormones, but the effect on colorectal cancer risk is unclear. Removal of the ovaries alters levels of sex hormones in both pre- and postmenopausal women. In premenopausal women, bilateral oophorectomy is followed by surgical menopause as the endogenous estrogen levels drop. Both before and after natural menopause, bilateral oophorectomy promptly decreases endogenous androgen levels by half as the ovaries and adrenals are equally important for androgen production.
MedicalResearch.com: What are the main findings?
Dr. Segelman: The present nationwide cohort study explored the association between removal of the ovaries for benign indications and subsequent risk of colorectal cancer. Among 195 973 women who underwent the procedure from 1965 – 2011, there was a 30% increased risk of colorectal cancer compared with the general population. After adjustment for various factors, women who underwent bilateral oophorectomy had a higher risk of rectal cancer than those who had unilateral oophorectomy (HR 2.28, 95% CI 1.33-3.91).
MedicalResearch.com: What should readers take away from your report?
Dr. Segelman: Reduced endogenous estrogen and androgen levels may be involved in the increased risk of colorectal cancer seen after oophorectomy in the current study. The findings highlights that prophylactic resection of normal ovaries should be reserved for women with a clear indication, such as a hereditary increased risk of ovarian cancer. Possible negative side-effects of the procedure should always be taken into account and discussed with the women preoperatively.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Segelman: The underlying biological mechanisms of sex hormones on colorectal carcinogenesis remain largely unknown. More investigations on the estrogen signaling in colorectal cancer may contribute to finding potential mechanisms for cancer prevention.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Br J Surg. 2016 Apr 26. doi: 10.1002/bjs.10143. [Epub ahead of print]
Population-based analysis of colorectal cancer risk after oophorectomy.
Segelman J1, Lindström L1, Frisell J1, Lu Y1,2.
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