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Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: results from the EPIC cohort

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Title: Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: results from the EPIC cohort
Authors: Fortner, RT
Ose, J
Merritt, MA
Schock, H
Tjonneland, A
Hansen, L
Overvad, K
Dossus, L
Clavel-Chapelon, F
Baglietto, L
Boeing, H
Trichopoulou, A
Benetou, V
Lagiou, P
Agnoli, C
Mattiello, A
Masala, G
Tumino, R
Sacerdote, C
Bueno-de-Mesquita, HBA
Onland-Moret, NC
Peeters, PH
Weiderpass, E
Gram, IT
Duell, EJ
Larranaga, N
Ardanaz, E
Sanchez, M-J
Chirlaque, M-D
Braendstedt, J
Idahl, A
Lundin, E
Khaw, K-T
Wareham, N
Travis, RC
Rinaldi, S
Romieu, I
Gunter, MJ
Riboli, E
Kaaks, R
Item Type: Journal Article
Abstract: Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (i.e., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone-related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone-related risk factors (follow-up: 1992–2010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (i.e., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] vs. type II [high grade serous or endometrioid]) for full-term pregnancy (phet = 0.02). Full-term pregnancy was more strongly inversely associated with type I than type II tumors (ever vs. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33–0.69]; type II, RR: 0.81 [0.61–1.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (e.g., ever full-term pregnancy: serous, RR: 0.73 [0.58–0.92]; mucinous, RR: 0.53 [0.30–0.95]; endometrioid, RR: 0.65 [0.40–1.06]; clear cell, RR: 0.34 [0.18–0.64]; phet = 0.16). These results suggest limited heterogeneity between reproductive and hormone-related risk factors and EOC subtypes.
Issue Date: 5-Feb-2015
Date of Acceptance: 20-Jan-2015
URI: http://hdl.handle.net/10044/1/42695
DOI: http;//dx.doi.org/10.1002/ijc.29471
ISSN: 1097-0215
Publisher: Wiley
Start Page: 1196
End Page: 1208
Journal / Book Title: International Journal of Cancer
Volume: 137
Issue: 5
Copyright Statement: © 2015 UICC
Keywords: Science & Technology
Life Sciences & Biomedicine
Oncology
ovarian cancer
reproductive factors
histologic subtype
dualistic model
ENDOMETRIAL CANCER
NUTRITION
OBESITY
AGE
Adult
Aged
Contraceptives, Oral, Hormonal
Europe
Female
Humans
Middle Aged
Neoplasms, Glandular and Epithelial
Ovarian Neoplasms
Pregnancy
Prospective Studies
Risk Factors
Term Birth
Oncology & Carcinogenesis
1112 Oncology And Carcinogenesis
Publication Status: Published
Appears in Collections:School of Public Health



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