The increased risk of colorectal cancer in the women who underwent hysterectomy from the South Korean National Health Insurance Database

Sep 24, 2026

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Background: Population-based and observational evidence suggests oophorectomy increases colorectal cancer (CRC) risk, while hormone replacement therapy may reduce it. This retrospective cohort study examined whether hysterectomy—by altering female hormone levels—is associated with risk of gastrointestinal tract cancers. Methods: Insurance data from South Korea’s HIRA were analyzed from 2007–2020. Results: CRC risk increased in hysterectomy groups, with rectal cancer higher after hysterectomy plus adnexal surgery, and GI cancer mortality increased after hysterectomy alone. Conclusions: Hysterectomy increased all CRC risk versus controls, with no association for other GI cancers.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Introduction

Hysterectomy and outcomes

Adnexal surgery and menopause

Yuk etal. BMC Women’s Health (2023) 23:519 [https://doi.org/10.1186/s12905-023-02642-3](https://doi.org/10.1186/s12905-023-02642-3) BMC Women’s Health RESEARCH Open Access The increased risk of colorectal cancer in the women who underwent hysterectomy from the South Korean National Health Insurance Database Jin ‑Sung Yuk1, Seung‑Woo Yang1, Sang‑Hee Yoon1, Myoung Hwan Kim1, Yong‑Soo Seo 1, Yujin Lee2, Jungbin Kim2, Keunho Yang2, Geumhee Gwak2 and Hyunjin Cho2,3* Abstract Background Several population‑based studies and observational studies have shown that oophorectomy is asso‑ ciated with an increased risk of colorectal cancer (CRC), and hormone replacement therapy has been associated with a reduction in the risk of colorectal cancer. This study was carried out to investigate whether hysterectomy, which may affect the levels of female hormones, is associated with a risk of cancer of the specific gastrointestinal tract. Methods This population‑based retrospective cohort study was conducted using insurance data provided by the Health Insurance Review and Assessment Service (HIRA) from January 1, 2007, to December 31, 2020. The hysterectomy group included 40‑ to 59‑year‑old women who underwent hysterectomy with uterine leiomyoma or uterine endometriosis from January 1, 2011, to December 31, 2014. The control group included women aged 40 to 59 years who visited medical institutions for medical examination from January 1, 2011 to December 31, 2014. Results The hysterectomy and non‑hysterectomhy groups comprised 66,204 and 89,768 subjects, respectively. The median ages in the non‑hysterectomy group and hysterectomy group were 48 (range: 43–53) and 46 (range: 44–49) years, respectively. In the unadjusted results of the analysis, all colorectal cancer (CRC) increased in the hyster‑ ectomy alone group (HR 1. 222, 95% confidence interval (CI) 1.016–1.47, p = 0 . 033), sigmoid colon cancer increased in the hysterectomy alone group (HR 1. 71, 95% CI 1.073–2. 724, p = 0 . 024), and rectal cancer increased in the hyster‑ ectomy with adnexal surgery group (HR 1. 924, 95% CI 1.073–2. 724, p = 0 . 002) . The adjusted results showed that all CRC increased in the hysterectomy alone group (HR 1.406, 95% CI 1.057–1. 871, p = 0 . 019), colon cancer increased in the hysterectomy alone group (HR 1. 523, 95% CI 1.068–2. 17, p = 0 . 02), and rectal cancer increased in the hyster‑ ectomy with adnexal surgery group (HR 1. 933, 95% CI 1.131–3. 302, p = 0 . 016) . The all‑cause mortality of GI cancer increased in the hysterectomy alone group (HR 3 .495, 95% CI 1.347–9. 07, p = 0 . 001) . Conclusions This study showed that the risk of all CRC increased in women who underwent hysterectomy com‑ pared with women who did not. In particular, the risk of rectal cancer was significantly higher in the women who underwent hysterectomy with adnexal surgery than in the controls. There was no association between hysterectomy and other GI cancers. *Correspondence: Hyunjin Cho [yourdoc@paik.ac.kr](yourdoc@paik.ac.kr) Full list of author information is available at the end of the article © The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creativecommons.org/licenses/by/4.0/](htt

FAQs

What was the main aim of this study?

To investigate whether hysterectomy is associated with the risk of specific gastrointestinal tract cancers, especially colorectal cancer, in women using South Korean national insurance data.

How were hysterectomy and control groups defined?

Women aged 40–59 who underwent hysterectomy for uterine leiomyoma or uterine endometriosis (2011–2014) formed the hysterectomy group, while controls were women aged 40–59 who visited medical institutions for medical examination during the same period.

What did the results show about colorectal and rectal cancer risk?

The adjusted analysis indicated increased risk of all CRC in the hysterectomy alone group, while rectal cancer increased significantly in the hysterectomy with adnexal surgery group compared with controls.

Sep 24, 2026

Uploaded by Pentious