BACKGROUND: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. METHODS: We pooled primary data from 13 population-based case-control studies, including 10,157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13,904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. RESULTS: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P < 0.001), endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P < 0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P < 0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P = 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P < 0.0001) and clear cell (P = 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. CONCLUSIONS: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.
BACKGROUND: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. METHODS: We pooled primary data from 13 population-based case-control studies, including 10,157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13,904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. RESULTS: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P < 0.001), endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P < 0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P < 0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P = 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P < 0.0001) and clear cell (P = 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. CONCLUSIONS: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.
Authors: V McGuire; A Felberg; M Mills; K L Ostrow; R DiCioccio; E M John; D W West; A S Whittemore Journal: Am J Epidemiol Date: 2004-10-01 Impact factor: 4.897
Authors: Urmila Chandran; Elisa V Bandera; Melony G Williams-King; Lisa E Paddock; Lorna Rodriguez-Rodriguez; Shou-En Lu; Shameka Faulkner; Katherine Pulick; Sara H Olson Journal: Cancer Causes Control Date: 2011-02-01 Impact factor: 2.506
Authors: Marc T Goodman; Galina Lurie; Pamela J Thompson; Katharine E McDuffie; Michael E Carney Journal: Endocr Relat Cancer Date: 2008-07-30 Impact factor: 5.678
Authors: Joellen M Schildkraut; Edwin S Iversen; Melanie A Wilson; Merlise A Clyde; Patricia G Moorman; Rachel T Palmieri; Regina Whitaker; Rex C Bentley; Jeffrey R Marks; Andrew Berchuck Journal: PLoS One Date: 2010-04-08 Impact factor: 3.240
Authors: Mary Anne Rossing; Kara L Cushing-Haugen; Kristine G Wicklund; Jennifer A Doherty; Noel S Weiss Journal: Cancer Epidemiol Biomarkers Prev Date: 2007-12 Impact factor: 4.254
Authors: Marie Soegaard; Allan Jensen; Estrid Høgdall; Lise Christensen; Claus Høgdall; Jan Blaakaer; Susanne K Kjaer Journal: Cancer Epidemiol Biomarkers Prev Date: 2007-06 Impact factor: 4.254
Authors: Joellen M Schildkraut; Lauren C Peres; Traci N Bethea; Fabian Camacho; Deanna Chyn; Emily K Cloyd; Elisa V Bandera; Alicia Beeghly-Fadiel; Loren Lipworth; Charlotte E Joslin; Faith G Davis; Patricia G Moorman; Evan Myers; Heather M Ochs-Balcom; Veronica Wendy Setiawan; Malcolm C Pike; Anna H Wu; Lynn Rosenberg Journal: Cancer Causes Control Date: 2019-06-24 Impact factor: 2.506
Authors: Lauren C Peres; Adrianne R Mallen; Mary K Townsend; Elizabeth M Poole; Britton Trabert; Naomi E Allen; Alan A Arslan; Laure Dossus; Renée T Fortner; Inger T Gram; Patricia Hartge; Annika Idahl; Rudolf Kaaks; Marina Kvaskoff; Anthony M Magliocco; Melissa A Merritt; J Ramón Quirós; Anne Tjonneland; Antonia Trichopoulou; Rosario Tumino; Carla H van Gils; Kala Visvanathan; Nicolas Wentzensen; Anne Zeleniuch-Jacquotte; Shelley S Tworoger Journal: Cancer Res Date: 2019-08-28 Impact factor: 12.701
Authors: Merlise A Clyde; Rachel Palmieri Weber; Edwin S Iversen; Elizabeth M Poole; Jennifer A Doherty; Marc T Goodman; Roberta B Ness; Harvey A Risch; Mary Anne Rossing; Kathryn L Terry; Nicolas Wentzensen; Alice S Whittemore; Hoda Anton-Culver; Elisa V Bandera; Andrew Berchuck; Michael E Carney; Daniel W Cramer; Julie M Cunningham; Kara L Cushing-Haugen; Robert P Edwards; Brooke L Fridley; Ellen L Goode; Galina Lurie; Valerie McGuire; Francesmary Modugno; Kirsten B Moysich; Sara H Olson; Celeste Leigh Pearce; Malcolm C Pike; Joseph H Rothstein; Thomas A Sellers; Weiva Sieh; Daniel Stram; Pamela J Thompson; Robert A Vierkant; Kristine G Wicklund; Anna H Wu; Argyrios Ziogas; Shelley S Tworoger; Joellen M Schildkraut Journal: Am J Epidemiol Date: 2016-10-03 Impact factor: 4.897
Authors: Rikki Cannioto; Michael J LaMonte; Harvey A Risch; Chi-Chen Hong; Lara E Sucheston-Campbell; Kevin H Eng; J Brian Szender; Jenny Chang-Claude; Barbara Schmalfeldt; Ruediger Klapdor; Emily Gower; Albina N Minlikeeva; Gary R Zirpoli; Elisa V Bandera; Andrew Berchuck; Daniel Cramer; Jennifer A Doherty; Robert P Edwards; Brooke L Fridley; Ellen L Goode; Marc T Goodman; Estrid Hogdall; Satoyo Hosono; Allan Jensen; Susan Jordan; Susanne K Kjaer; Keitaro Matsuo; Roberta B Ness; Catherine M Olsen; Sara H Olson; Celeste Leigh Pearce; Malcolm C Pike; Mary Anne Rossing; Elizabeth A Szamreta; Pamela J Thompson; Chiu-Chen Tseng; Robert A Vierkant; Penelope M Webb; Nicolas Wentzensen; Kristine G Wicklund; Stacey J Winham; Anna H Wu; Francesmary Modugno; Joellen M Schildkraut; Kathryn L Terry; Linda E Kelemen; Kirsten B Moysich Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-05-06 Impact factor: 4.254