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—In response to Dr Myers, we unfortunately do not have data on the type of hysterectomy procedure performed (vaginal or abdominal). In response to Dr Silver, we asked women about their use of contraceptive foam or jelly on the first three study questionnaires. Only 6040 women reported use in 1976; reported use decreased on each subsequent questionnaire. In a multivariate analysis controlling for other ovarian cancer risk factors, the relative risk associated with use of foam or jelly was 0.60 with wide 95% confidence limits (0.24, 1.46); thus, further follow-up will be needed. As described in our article, we agree that a possible mechanism is the prevention of ovarian exposure by contaminants other than talc. We do not concur with Dr Wahlberg's observation that our data indicate a protective effect of condom use; the relative risk, although less than 1.0, was not near statistical significance. Dr Whitmore makes
Hankinson SE, Hunter DJ, Colditz GA, Speizer FE. Tubal Ligation, Hysterectomy, and Risk of Ovarian Cancer-Reply. JAMA. 1994;271(16):1236-1237. doi:10.1001/jama.1994.03510400021015