Hormonal and Reproductive Risk Factors for Epithelial Ovarian Cancer by Tumor Aggressiveness

• DOI: 10.1158/1055-9965.epi-12-1183-t
• Publication Date: 2013-01-11T05:20:44Z
• Authors: Elizabeth M. Poole; Melissa A. Merritt; Susan J. Jordan; Hannah P. Yang; Susan E. Hankinson; Yikung Park; Bernard Rosner; Penelope M. Webb; Daniel W. Cramer; Nicolas Wentzensen; Kathryn L. Terry; Shelley S. Tworoger
• Keywords: Adult; Survival; 610; Nurses; Carcinoma, Ovarian Epithelial; Hysterectomy; 03 medical and health sciences; 0302 clinical medicine; Meta-Analysis as Topic; New England; Pregnancy; Humans; Women; Neoplasms, Glandular and Epithelial; Prospective Studies; Progesterone; Aged; Neoplasm Staging; Ovarian Neoplasms; Cohort; Middle Aged; Prognosis; 3. Good health; Parity; Health; Case-Control Studies; Surgery; 2730 Oncology; Female; 2713 Epidemiology; Contraceptives, Oral; Follow-Up Studies

Abstract Background: Approximately half of epithelial ovarian cancers are fatal within 3 years; however, roughly 35% women survive for at least 10 years. In the Nurses' Health Study, New England Case-Control Australian Ovarian Cancer and NIH-AARP Diet we investigated potential differences in associations with cancer risk factors by tumor aggressiveness, defined on basis time from diagnosis until death. Methods: We calculated relative risks (RR) 95% confidence intervals (CI) known or suspected rapidly (death years diagnosis) less aggressive tumors (all others) using Cox proportional hazards competing analysis (NHS AARP) polytomous logistic regression (NECC, AOCS). Results were combined random effects meta-analysis. Results: Increasing age was associated greater versus disease (RR, 5-year increase: 1.39; CI, 1.29–1.49 vs. RR, 1.09; 1.03–1.16, respectively; Pdiff < 0.0001). Oral contraceptive use a decreased 0.69; 0.58–0.82) 0.81; 0.74–0.89; Pdiff, 0.002). Conversely, increasing parity only (RR per child, 0.87; 0.81–0.93). Conclusion: this 4,342 cases, there clear tumors. Impact: Differences factor aggressiveness suggests developmental pathways through which develop may be important developing primary preventive strategies most cancers. Epidemiol Biomarkers Prev; 22(3); 429–36. ©2013 AACR.