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  • Wentzensen, NicolasNCI, Bethesda, MD 20892 USA. (author)

Ovarian Cancer Risk Factors by Histologic Subtype : An Analysis From the Ovarian Cancer Cohort Consortium

  • Article/chapterEnglish2016

Publisher, publication year, extent ...

  • AMER SOC CLINICAL ONCOLOGY,2016
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:umu-126368
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-126368URI
  • https://doi.org/10.1200/JCO.2016.66.8178DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-422328URI
  • http://kipublications.ki.se/Default.aspx?queryparsed=id:134132751URI

Supplementary language notes

  • Language:English
  • Summary in:English

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

Notes

  • Purpose: An understanding of the etiologic heterogeneity of ovarian cancer is important for improving prevention, early detection, and therapeutic approaches. We evaluated 14 hormonal, reproductive, and lifestyle factors by histologic subtype in the Ovarian Cancer Cohort Consortium (OC3).Patients and Methods: Among 1.3 million women from 21 studies, 5,584 invasive epithelial ovarian cancers were identified (3,378 serous, 606 endometrioid, 331 mucinous, 269 clear cell, 1,000 other). By using competing-risks Cox proportional hazards regression stratified by study and birth year and adjusted for age, parity, and oral contraceptive use, we assessed associations for all invasive cancers by histology. Heterogeneity was evaluated by likelihood ratio test.Results: Most risk factors exhibited significant heterogeneity by histology. Higher parity was most strongly associated with endometrioid (relative risk [RR] per birth, 0.78; 95% CI, 0.74 to 0.83) and clear cell (RR, 0.68; 95% CI, 0.61 to 0.76) carcinomas (P value for heterogeneity [P-het] < .001). Similarly, age at menopause, endometriosis, and tubal ligation were only associated with endometrioid and clear cell tumors (P-het ≤ .01). Family history of breast cancer (P-het = .008) had modest heterogeneity. Smoking was associated with an increased risk of mucinous (RR per 20 pack-years, 1.26; 95% CI, 1.08 to 1.46) but a decreased risk of clear cell (RR, 0.72; 95% CI, 0.55 to 0.94) tumors (P-het = .004). Unsupervised clustering by risk factors separated endometrioid, clear cell, and low-grade serous carcinomas from high-grade serous and mucinous carcinomas.Conclusion: The heterogeneous associations of risk factors with ovarian cancer subtypes emphasize the importance of conducting etiologic studies by ovarian cancer subtypes. Most established risk factors were more strongly associated with nonserous carcinomas, which demonstrate challenges for risk prediction of serous cancers, the most fatal subtype.

Subject headings and genre

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  • Poole, Elizabeth M.NCI, Bethesda, MD 20892 USA.;Brigham & Womens Hosp, Boston, MA 02115 USA.;Harvard Univ, Boston, MA 02115 USA. (author)
  • Trabert, BrittonNCI, Bethesda, MD 20892 USA. (author)
  • White, EmilyFred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA. (author)
  • Arslan, Alan A.NYU, Sch Med, New York, NY 10003 USA.,NCI, Bethesda, MD 20892 USA.,Imperial Coll London, London, England.,Maastricht Univ, Maastricht, Netherlands. (author)
  • Patel, Alpa V.Amer Canc Soc, Atlanta, GA 30329 USA. (author)
  • Setiawan, V. WendyUniv Southern Calif, Los Angeles, CA USA. (author)
  • Visvanathan, KalaJohns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA. (author)
  • Weiderpass, ElisabeteKarolinska Institutet (author)
  • Adami, Hans-OlovKarolinska Institutet (author)
  • Black, AmandaNCI, Bethesda, MD 20892 USA. (author)
  • Bernstein, LeslieCity Hope Natl Med Ctr, Duarte, CA USA. (author)
  • Brinton, Louise A. (author)
  • Buring, JulieBrigham & Womens Hosp, Boston, MA 02115 USA.;Harvard Univ, Boston, MA 02115 USA. (author)
  • Butler, Lesley M.Univ Pittsburgh, Pittsburgh, PA USA. (author)
  • Chamosa, SaioaBioDonostia Res Inst, San Sebastian, Spain. (author)
  • Clendenen, Tess V.NYU, Sch Med, New York, NY 10003 USA. (author)
  • Dossus, LaureFrench Inst Hlth & Med Res, Paris, France. (author)
  • Fortner, ReneeGerman Canc Res Ctr, Heidelberg, Germany. (author)
  • Gapstur, Susan M.Amer Canc Soc, Atlanta, GA 30329 USA. (author)
  • Gaudet, Mia M.Amer Canc Soc, Atlanta, GA 30329 USA. (author)
  • Gram, Inger T.Univ Tromso Arctic Univ Norway, Tromso, Norway. (author)
  • Hartge, PatriciaNCI, Bethesda, MD 20892 USA. (author)
  • Hoffman-Bolton, JudithJohns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD USA. (author)
  • Idahl, AnnikaUmeå universitet,Obstetrik och gynekologi,Umea Univ, Umea, Sweden.(Swepub:umu)anid0002 (author)
  • Jones, MichaelInst Canc Res, Sutton, Surrey, England. (author)
  • Kaaks, RudolfGerman Canc Res Ctr, Heidelberg, Germany. (author)
  • Kirsh, VictoriaUniv Toronto, Toronto, ON, Canada. (author)
  • Koh, Woon-PuayDuke Univ, Singapore, Singapore. (author)
  • Lacey, James V., Jr.City Hope Natl Med Ctr, Duarte, CA USA. (author)
  • Lee, I-MinBrigham & Womens Hosp, Boston, MA 02115 USA.;Harvard Univ, Boston, MA 02115 USA. (author)
  • Lundin, EvaUmeå universitet,Institutionen för medicinsk biovetenskap,Umea Univ, Umea, Sweden.(Swepub:umu)evlu0001 (author)
  • Merritt, Melissa A. (author)
  • Onland-Moret, N. CharlotteUniv Med Ctr Utrecht, Utrecht, Netherlands. (author)
  • Peters, UlrikeFred Hutchinson Canc Res Ctr, 1124 Columbia St, Seattle, WA 98104 USA. (author)
  • Poynter, Jenny N.Univ Minnesota, Minneapolis, MN USA. (author)
  • Rinaldi, SabinaInt Agcy Res Canc, Lyon, France. (author)
  • Robien, KimGeorge Washington Univ, Washington, DC USA. (author)
  • Rohan, ThomasAlbert Einstein Coll Med, New York, NY USA. (author)
  • Sandler, Dale P.NIEHS, Bethesda, MD USA. (author)
  • Schairer, CatherineNCI, Bethesda, MD 20892 USA. (author)
  • Schouten, Leo J.Maastricht Univ, Maastricht, Netherlands. (author)
  • Sjoholm, Louise K.Karolinska Institutet (author)
  • Sieri, SabinaNatl Canc Inst, Rome, Italy.,Brigham & Womens Hosp, Boston, MA 02115 USA.;Harvard Univ, Boston, MA 02115 USA. (author)
  • Swerdlow, AnthonyInst Canc Res, Sutton, Surrey, England. (author)
  • Tjonneland, AnnaDanish Canc Soc, Copenhagen, Denmark. (author)
  • Travis, RuthUniv Oxford, Oxford, England. (author)
  • Trichopoulou, AntoniaHellenic Hlth Fdn, Athens, Greece. (author)
  • van den Brandt, Piet A. (author)
  • Wilkens, LynneUniv Hawaii, Ctr Canc, Honolulu, HI 96822 USA. (author)
  • Wolk, AlicjaKarolinska Institutet (author)
  • Yang, Hannah P.NCI, Bethesda, MD 20892 USA. (author)
  • Zeleniuch-Jacquotte, AnneNYU, Sch Med, New York, NY 10003 USA. (author)
  • Tworoger, Shelley S. (author)
  • NCI, Bethesda, MD 20892 USA.NCI, Bethesda, MD 20892 USA.;Brigham & Womens Hosp, Boston, MA 02115 USA.;Harvard Univ, Boston, MA 02115 USA. (creator_code:org_t)

Related titles

  • In:Journal of Clinical Oncology: AMER SOC CLINICAL ONCOLOGY34:24, s. 2888-28980732-183X1527-7755

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