{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T01:05:53Z","timestamp":1789520753399,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The impact of hysterectomy and bilateral oophorectomy on future mortality risk is still debated. Self\u2010reported exposure may be a major source of bias in many studies. We aimed to determine mortality following hospital\u2010reported hysterectomy and bilateral oophorectomy and compare to results based on self\u2010reported surgeries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>We included 37\u2009140 women from the second (1995\u20131997) and third (2006\u20132008) HUNT surveys. HUNT (the Tr\u00f8ndelag Health Study) is a population\u2010based Norwegian cohort study, and we linked to the Norwegian Cause of Death Registry, the Cancer Registry of Norway, and hospital surgical codes. The participants were followed from inclusion in HUNT until December 2020. Women were classified as unexposed, exposed to hysterectomy alone, exposed to bilateral oophorectomy alone, or exposed to both surgeries. Hospital\u2010reported exposure was determined using surgical procedure codes, whereas self\u2010reported exposure was obtained from the HUNT questionnaires. To be classified as exposed based on self\u2010report, a woman had to indicate that she had undergone the surgery and provide her age at the time of the procedure. We compared the hazard of death in unexposed vs. exposed groups using Cox regression analysis, adjusting for relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with unexposed women, hospital\u2010reported hysterectomy was associated with a reduced hazard of death (HR 0.72 [95% CI 0.62\u20130.84]), while\n                      <jats:italic>self\u2010reported<\/jats:italic>\n                      hysterectomy showed no association (HR 1.06 [95% CI 0.97\u20131.16]). For bilateral oophorectomy, hospital\u2010reported cases showed an HR of 0.83 (95% CI 0.64\u20131.07), while\n                      <jats:italic>self\u2010reported<\/jats:italic>\n                      cases indicated an HR of 1.14 (95% CI 0.97\u20131.33). Women who had both hysterectomy and bilateral oophorectomy demonstrated no significant association with mortality, regardless of whether the surgeries were hospital\u2010reported (HR 1.13 [95% CI 0.96\u20131.34]) or self\u2010reported (0.93 [95% CI 0.82\u20131.06]). Early hospital\u2010reported bilateral oophorectomy was associated with an increased hazard of death, particularly when performed before the age of 50.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Results differed between hospital\u2010reported and self\u2010reported exposure. This could explain the heterogeneity observed in previous studies on mortality risk after hysterectomy and oophorectomy. In this study, hospital\u2010reported hysterectomy and bilateral oophorectomy were not associated with increased mortality, whereas early bilateral oophorectomy was.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aogs.70354","type":"journal-article","created":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:15:46Z","timestamp":1789517746000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["All\u2010cause mortality after self\u2010reported vs. hospital\u2010reported gynecological surgery: The\n                    <scp>HUNT<\/scp>\n                    study"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9718-5635","authenticated-orcid":false,"given":"Tina Ellinor","family":"Rosland","sequence":"first","affiliation":[{"name":"Research Unit\/Department of Obstetrics and Gynecology S\u00f8rlandet Hospital HF  Kristiansand\/Arendal Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nora","family":"Johansen","sequence":"additional","affiliation":[{"name":"Research Unit\/Department of Obstetrics and Gynecology S\u00f8rlandet Hospital HF  Kristiansand\/Arendal Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid Helene","family":"Liavaag","sequence":"additional","affiliation":[{"name":"Research Unit\/Department of Obstetrics and Gynecology S\u00f8rlandet Hospital HF  Kristiansand\/Arendal Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3837-2101","authenticated-orcid":false,"given":"Bj\u00f8rn Olav","family":"\u00c5svold","sequence":"additional","affiliation":[{"name":"HUNT Center for Molecular and Clinical Epidemiology, Department of Public Health and Nursing Norwegian University of Science and Technology  Trondheim Norway"},{"name":"Department of Endocrinology, Clinic of Medicine, St. Olavs Hospital Trondheim University Hospital  Trondheim Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-7309","authenticated-orcid":false,"given":"Are Hugo","family":"Pripp","sequence":"additional","affiliation":[{"name":"Oslo Centre of Biostatistics and Epidemiology, Research Support Services Oslo University Hospital  Oslo Norway"},{"name":"Faculty of Health Sciences Oslo Metropolitan University  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9534-6255","authenticated-orcid":false,"given":"Trond Melbye","family":"Michelsen","sequence":"additional","affiliation":[{"name":"Research Unit\/Department of Obstetrics and Gynecology S\u00f8rlandet Hospital HF  Kristiansand\/Arendal Norway"},{"name":"Department of Obstetrics, Division of Obstetrics and Gynecology Oslo University Hospital  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"crossref","first-page":"1444","DOI":"10.1111\/1471-0528.17843","article-title":"Examining the association of hysterectomy with and without oophorectomy on cardiovascular disease and all\u2010cause, cardiovascular or cancer mortality: a systematic review and meta\u2010analysis","volume":"131","author":"Chen Y","year":"2024","journal-title":"BJOG"},{"issue":"1","key":"e_1_2_14_3_1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1097\/GME.0000000000001873","article-title":"Cardiovascular mortality after bilateral oophorectomy: a prospective cohort study","volume":"29","author":"Olesen CS","year":"2021","journal-title":"Menopause"},{"key":"e_1_2_14_4_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.j372","article-title":"Removal of all ovarian tissue versus conserving ovarian tissue at time of hysterectomy in premenopausal patients with benign disease: study using routine data and data linkage","volume":"356","author":"Mytton J","year":"2017","journal-title":"BMJ"},{"issue":"6","key":"e_1_2_14_5_1","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1097\/GME.0000000000000118","article-title":"Long\u2010term overall and disease\u2010specific mortality associated with benign gynecologic surgery performed at different ages","volume":"21","author":"Gierach GL","year":"2014","journal-title":"Menopause"},{"key":"e_1_2_14_6_1","doi-asserted-by":"crossref","first-page":"653.e1","DOI":"10.1016\/j.ajog.2024.02.007","article-title":"Excess morbidity and mortality associated with underuse of estrogen replacement therapy in premenopausal women who undergo surgical menopause","volume":"230","author":"Ferris JS","year":"2024","journal-title":"Am J Obstet Gynecol"},{"key":"e_1_2_14_7_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmj-2021-067528","article-title":"Association of 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The survey of Women's health study group","volume":"21","author":"Green A","year":"1997","journal-title":"Aust N Z J Public Health"},{"issue":"3","key":"e_1_2_14_10_1","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2013-004421","article-title":"Validity of self\u2010reported hysterectomy: a prospective cohort study within the UK collaborative trial of ovarian cancer screening (UKCTOCS)","volume":"4","author":"Gentry\u2010Maharaj A","year":"2014","journal-title":"BMJ Open"},{"issue":"10","key":"e_1_2_14_11_1","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.2105\/AJPH.84.10.1653","article-title":"Hysterectomy use: the correspondence between self\u2010reports and hospital records","volume":"84","author":"Brett KM","year":"1994","journal-title":"Am J Public Health"},{"issue":"4","key":"e_1_2_14_12_1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/aogs.14531","article-title":"All\u2010cause and cardiovascular mortality after hysterectomy and oophorectomy in a large cohort (HUNT2)","volume":"102","author":"Michelsen TM","year":"2023","journal-title":"Acta Obstet Gynecol Scand"},{"key":"e_1_2_14_13_1","doi-asserted-by":"crossref","first-page":"1555","DOI":"10.1111\/1471-0528.17859","article-title":"Validity of self\u2010reported hysterectomy and oophorectomy in a population\u2010based cohort: the HUNT study","volume":"131","author":"Rosland TE","year":"2024","journal-title":"BJOG"},{"issue":"4","key":"e_1_2_14_14_1","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1093\/ije\/dys095","article-title":"Cohort profile: the HUNT study, Norway","volume":"42","author":"Krokstad S","year":"2013","journal-title":"Int J Epidemiol"},{"issue":"1","key":"e_1_2_14_15_1","doi-asserted-by":"crossref","first-page":"e80","DOI":"10.1093\/ije\/dyac095","article-title":"Cohort profile update: the HUNT study, Norway","volume":"52","author":"\u00c5svold BO","year":"2023","journal-title":"Int J Epidemiol"},{"key":"e_1_2_14_16_1","unstructured":"Health NIoP.Slik kodes og kvalitetssikres d\u00f8ds\u00e5rsaker i D\u00f8ds\u00e5rsaksregisteret. 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Available from:https:\/\/www.fhi.no\/op\/dodsarsaksregisteret\/dodsarsaken\u2010kodes\u2010med\u2010icd\u2010koder\/."},{"issue":"1","key":"e_1_2_14_17_1","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1097\/gme.0b013e31818888f7","article-title":"Increased cardiovascular mortality after early bilateral oophorectomy","volume":"16","author":"Rivera CM","year":"2009","journal-title":"Menopause"},{"issue":"6","key":"e_1_2_14_18_1","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1093\/eurheartj\/ehq477","article-title":"Hysterectomy and risk of cardiovascular disease: a population\u2010based cohort study","volume":"32","author":"Ingelsson E","year":"2011","journal-title":"Eur Heart J"},{"issue":"5","key":"e_1_2_14_19_1","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1097\/GME.0000000000001043","article-title":"Cardiovascular and metabolic morbidity after hysterectomy with ovarian conservation: a cohort study","volume":"25","author":"Laughlin\u2010Tommaso SK","year":"2018","journal-title":"Menopause"},{"issue":"5","key":"e_1_2_14_20_1","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1097\/AOG.0000000000004732","article-title":"A revised Markov model evaluating oophorectomy at the time of hysterectomy for benign indication: age 65\u2009years revisited","volume":"139","author":"Rueh SK","year":"2022","journal-title":"Obstet Gynecol"},{"issue":"5","key":"e_1_2_14_21_1","doi-asserted-by":"crossref","DOI":"10.1016\/j.ajog.2020.04.037","article-title":"Hysterectomy with and without oophorectomy and all\u2010cause and cause\u2010specific mortality","volume":"223","author":"Tuesley KM","year":"2020","journal-title":"Am J Obstet Gynecol"}],"container-title":["Acta Obstetricia et Gynecologica Scandinavica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70354","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/aogs.70354","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aogs.70354","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T00:15:49Z","timestamp":1789517749000},"score":1,"resource":{"primary":{"URL":"https:\/\/obgyn.onlinelibrary.wiley.com\/doi\/10.1111\/aogs.70354"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":20,"alternative-id":["10.1111\/aogs.70354"],"URL":"https:\/\/doi.org\/10.1111\/aogs.70354","archive":["Portico"],"relation":{},"ISSN":["0001-6349","1600-0412"],"issn-type":[{"value":"0001-6349","type":"print"},{"value":"1600-0412","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"2025-09-26","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"aogs.70354"}}