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  • Sköld, CamillaUppsala universitet,Experimentell och klinisk onkologi (author)

Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women

  • Article/chapterEnglish2018

Publisher, publication year, extent ...

  • 2018-07-10
  • Wiley,2018
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:uu-364126
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-364126URI
  • https://doi.org/10.1002/ijc.31581DOI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:139115902URI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy-related factors on risk is not well understood. This population-based case-control study included all parous women with epithelial ovarian cancer in Denmark, Finland, Norway and Sweden during 1967-2013 (n = 10,957) and up to 10 matched controls (n = 107,864). We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for pregnancy-related factors and ovarian cancer risk by histological subtype. Preterm delivery was associated with an increased risk [pregnancy length (last pregnancy) 30 vs. 39-41 weeks, OR 1.33 (95% CI 1.06-1.67), adjusted for number of births]; the OR increased as pregnancy length decreased (p for trend < 0.001). Older age at first and last birth was associated with a decreased risk [first birth: 30-39 vs. <25 years: adjusted OR 0.76 (95% CI 0.70-0.83); last birth 30-39 vs. <25 years: adjusted OR 0.76 (95% CI 0.71-0.82)]. Increasing number of births was protective [>= 4 births vs. 1; OR 0.63 (95% CI 0.59-0.68)] for all subtypes, most pronounced for clear-cell tumors [OR 0.30, (95% CI 0.21-0.44), p(heterogeneity)<0.001]. No associations were observed for multiple pregnancies, preeclampsia or offspring size. In conclusion, in addition to high parity, full-term pregnancies and pregnancies at older ages were associated with decreased risk of ovarian cancer. Our findings favor the cell clearance hypothesis, i.e. a recent pregnancy provides protection by clearing of precancerous cells from the epithelium of the ovary/fallopian tubes, mediated by placental or ovarian hormones.

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Added entries (persons, corporate bodies, meetings, titles ...)

  • Bjorge, ToneUniv Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway;Canc Registry Norway, Oslo, Norway (author)
  • Ekbom, AndersKarolinska Institutet (author)
  • Engeland, AndersUniv Bergen, Dept Global Publ Hlth & Primary Care, Bergen, Norway;Norwegian Inst Publ Hlth, Dept Pharmacoepidemiol, Bergen, Norway (author)
  • Gissler, MikaKarolinska Institutet (author)
  • Grotmol, TomCanc Registry Norway, Oslo, Norway (author)
  • Madanat-Harjuoja, LauraFinnish Canc Registry, Canc Soc Finland, Helsinki, Finland;Univ Helsinki, Dept Paediat, Helsinki, Finland;Helsinki Univ Hosp, Helsinki, Finland (author)
  • Ording, Anne GulbechAarhus Univ Hosp, Dept Clin Epidemiol, Aarhus, Denmark (author)
  • Stephansson, OlofKarolinska Institutet (author)
  • Trabert, BrittonNCI, Div Canc Epidemiol & Genet, Dept Hlth & Human Serv, Dept Hlth & Human Serv,NIH, Bethesda, MD 20892 USA (author)
  • Tretli, SteinarCanc Registry Norway, Oslo, Norway (author)
  • Troisi, RebeccaNCI, Div Canc Epidemiol & Genet, Dept Hlth & Human Serv, Dept Hlth & Human Serv,NIH, Bethesda, MD 20892 USA (author)
  • Sorensen, Henrik ToftAarhus Univ Hosp, Dept Clin Epidemiol, Aarhus, Denmark (author)
  • Glimelius, Ingrid,1975-Karolinska Institutet,Uppsala universitet,Experimentell och klinisk onkologi,Karolinska Inst, Clin Epidemiol Unit, Dept Med, Stockholm, Sweden(Swepub:uu)inggl846 (author)
  • Uppsala universitetExperimentell och klinisk onkologi (creator_code:org_t)

Related titles

  • In:International Journal of Cancer: Wiley143:8, s. 1858-18670020-71361097-0215

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