Author Affiliations: Department of Medical Epidemiology and Biostatistics and Division of Obstetrics and Gynecology, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden.
In lieu of other explanations for the observed association between hysterectomy and renal cancer, we welcome the argument put forth by Drs Goldstein and Mascitelli. Indeed, the suggested influences of VEGF and iron accumulation on the association are 2 biologically plausible explanations worthy of further exploration because they are amenable to intervention in women with an increased risk. Although our study provides robust epidemiological evidence linking hysterectomy with an increased risk for renal cancer later in life, we recognize the need for further clinical and experimental research to substantiate our findings and to determine why (and which) younger women in particular are at increased risk for renal cancer after hysterectomy on benign indications.
Altman D. Risk of Renal Cell Carcinoma After Hysterectomy: Is It All Obesity?—Reply. Arch Intern Med. 2011;171(13):1215–1216. doi:10.1001/archinternmed.2011.304