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Secondary outcomes were non-cancer and cancer death. Within each age group, overlap propensity score weighted survival models were used to examine the association between bilateral salpingo-oophorectomy and mortality outcomes, while adjusting for demographic characteristics, gynaecological conditions, and comorbidities. To account for comparisons in four age groups, P&lt;0.0125 was considered statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Bilateral salpingo-oophorectomy was performed in 19%, 41%, 69%, and 81% of women aged &lt;45, 45-49, 50-54, and \u226555 years, respectively. The procedure was associated with increased rates of all cause death in women aged &lt;45 years (hazard ratio 1.31, 95% confidence interval 1.18 to 1.45, P&lt;0.001; number needed to harm 71 at 20 years) and 45-49 years (1.16, 1.04 to 1.30, P=0.007; 152 at 20 years), but not in women aged 50-54 years (0.83, 0.72 to 0.97, P=0.018) or \u226555 years (0.92, 0.82 to 1.03, P=0.16). Findings in women aged &lt;50 years were driven largely by increased non-cancer death. In secondary analyses identifying a possible change in the association between bilateral salpingo-oophorectomy and all cause death with advancing age at surgery, the hazard ratio gradually decreased during the menopausal transition and remained around 1 at all ages thereafter.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this observational study, bilateral salpingo-oophorectomy at non-malignant hysterectomy appeared to be associated with increased all cause mortality in women aged &lt;50 years, but not in those aged \u226550 years. While caution is warranted when considering bilateral salpingo-oophorectomy in premenopausal women without indication, this strategy for ovarian cancer risk reduction does not appear to be detrimental to survival in postmenopausal women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2021-067528","type":"journal-article","created":{"date-parts":[[2021,12,8]],"date-time":"2021-12-08T20:25:37Z","timestamp":1638995137000},"page":"e067528","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":46,"title":["Association of bilateral salpingo-oophorectomy with all cause and cause specific mortality: population based cohort study"],"prefix":"10.1136","volume":"375","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1661-4846","authenticated-orcid":false,"given":"Maria C","family":"Cusimano","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON, 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