Anita Koushik1,2, Anne Grundy3,4, Michal Abrahamowicz5,6, Jocelyne Arseneau7,8, Lucy Gilbert8, Walter H Gotlieb9, Julie Lacaille3, Anne-Marie Mes-Masson3,10, Marie-Élise Parent3,4,11, Diane M Provencher3,12, Lesley Richardson3, Jack Siemiatycki3,4. 1. Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada. anita.koushik@umontreal.ca. 2. Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada. anita.koushik@umontreal.ca. 3. Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada. 4. Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada. 5. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada. 6. Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montreal, QC, Canada. 7. Department of Pathology, McGill University Health Centre, Montreal, QC, Canada. 8. Gynecologic Oncology Unit, McGill University Health Centre, Montreal, QC, Canada. 9. Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC, Canada. 10. Department of Medicine, Université de Montréal, Montreal, QC, Canada. 11. INRS-Institut Armand-Frappier, University of Quebec, Laval, QC, Canada. 12. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada.
Abstract
PURPOSE: Hormone-related factors have been associated with ovarian cancer, the strongest being parity and oral contraceptive use. Given reductions in birth rates and increases in oral contraceptive use over time, associations in more recent birth cohorts may differ. Furthermore, consideration of ovarian cancer heterogeneity (i.e., Type I/II invasive cancers) may contribute to a better understanding of etiology. We examined hormone-related factors in relation to ovarian cancer risk overall, for Type I and Type II cancers, as well as borderline tumors. METHODS: A population-based case-control study was carried out in Montreal, Canada from 2011 to 2016, including 496 cases and 908 controls. For each hormone-related variable, adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression for ovarian cancer overall, and using polytomous logistic regression for associations by tumor behavior and ovarian cancer type. RESULTS: Parity was inversely associated with risk overall and by tumor behavior and type, with a stronger OR (95% CI) for Type I [0.09 (0.04-0.24) for ≥3 full-term births vs. nulliparity] vs. Type II [0.66 (0.43-1.02)] invasive cancers; the OR (95% CI) for borderline tumors was 0.41 (0.22-0.77). Oral contraceptive ever use was not associated with risk overall, but ≥10 years of use vs. never use reduced risk, particularly for invasive cancers. A history of endometriosis was most strongly associated with Type I cancers. Associations with other factors were less clear. CONCLUSIONS: These results suggest that associations with some hormone-related factors may differ between borderline and invasive Type I and II ovarian cancers.
PURPOSE: Hormone-related factors have been associated with ovarian cancer, the strongest being parity and oral contraceptive use. Given reductions in birth rates and increases in oral contraceptive use over time, associations in more recent birth cohorts may differ. Furthermore, consideration of ovarian cancer heterogeneity (i.e., Type I/II invasive cancers) may contribute to a better understanding of etiology. We examined hormone-related factors in relation to ovarian cancer risk overall, for Type I and Type II cancers, as well as borderline tumors. METHODS: A population-based case-control study was carried out in Montreal, Canada from 2011 to 2016, including 496 cases and 908 controls. For each hormone-related variable, adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression for ovarian cancer overall, and using polytomous logistic regression for associations by tumor behavior and ovarian cancer type. RESULTS: Parity was inversely associated with risk overall and by tumor behavior and type, with a stronger OR (95% CI) for Type I [0.09 (0.04-0.24) for ≥3 full-term births vs. nulliparity] vs. Type II [0.66 (0.43-1.02)] invasive cancers; the OR (95% CI) for borderline tumors was 0.41 (0.22-0.77). Oral contraceptive ever use was not associated with risk overall, but ≥10 years of use vs. never use reduced risk, particularly for invasive cancers. A history of endometriosis was most strongly associated with Type I cancers. Associations with other factors were less clear. CONCLUSIONS: These results suggest that associations with some hormone-related factors may differ between borderline and invasive Type I and II ovarian cancers.
Entities:
Keywords:
Case–control study; Hormones; Ovarian cancer; Reproductive factors; Type I/II
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