Chrissy McNamara1, Sarah E Abbott2, Elisa V Bandera3, Bo Qin3, Lauren C Peres2, Fabian Camacho2, Patricia G Moorman4, Anthony J Alberg5, Jill S Barnholtz-Sloan6, Melissa Bondy7, Michele L Cote8, Ellen Funkhouser9, Edward S Peters10, Ann G Schwartz8, Joellen M Schildkraut2, Paul Terry11. 1. Georgia Comprehensive Cancer Registry, Georgia Department of Public Health, Atlanta, GA, USA. 2. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA. 3. Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 4. Department of Community and Family Medicine, Duke Cancer Institute, Durham, NC, USA. 5. Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC, USA. 6. Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA. 7. Cancer Prevention and Population Sciences Program, Baylor College of Medicine, Houston, TX, USA. 8. Department of Oncology and the Karmanos Cancer Institute, Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI, USA. 9. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 10. Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA. 11. Department of Medicine, The University of Tennessee Graduate School of Medicine, 1924 Alcoa Highway Box U-114, Knoxville, TN, 37920, USA. pterry@utmck.edu.
Abstract
PURPOSE: Tubal ligation has been associated with reduced risk of epithelial ovarian cancer (EOC) in studies of primarily white women, but less is known about the association in African American (AA) women. We sought to evaluate the associations among 597 invasive ovarian cancer cases and 742 controls of AA descent recruited from the African American Cancer Epidemiology Study, a population-based case-control study in 11 geographical areas in the US. METHODS: Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for potentially confounding factors. RESULTS: An inverse association between tubal ligation and EOC was observed that was not statistically significant (OR 0.88, 95% CI 0.68-1.14). However, an inverse association with EOC risk was observed among women who had a tubal ligation at age 35 years or older (OR 0.64; 95% CI 0.41-0.98), but not among those who had a tubal ligation before age 35 (OR 0.98; 95% CI 0.74-1.29) (p for interaction = 0.08). The association also varied considerably by tumor subtype. A strong inverse association was observed for endometrioid tumors (OR 0.31, 95% CI 0.14-0.70), whereas associations with mucinous (OR 0.87, 95% CI 0.36-2.12) and serous (OR 0.94, 95% CI 0.71-1.24) tumors were weaker and not statistically significant. A statistically non-significant positive association for clear cell tumors (OR 1.84, 95% CI 0.58-5.82) was based on a low number of cases. CONCLUSIONS: Our findings show that tubal ligation may confer a reduced risk for EOC among AA women that is comparable to the associations that have been previously observed in primarily white populations.
PURPOSE: Tubal ligation has been associated with reduced risk of epithelial ovarian cancer (EOC) in studies of primarily white women, but less is known about the association in African American (AA) women. We sought to evaluate the associations among 597 invasive ovarian cancer cases and 742 controls of AA descent recruited from the African American Cancer Epidemiology Study, a population-based case-control study in 11 geographical areas in the US. METHODS: Multivariable logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusted for potentially confounding factors. RESULTS: An inverse association between tubal ligation and EOC was observed that was not statistically significant (OR 0.88, 95% CI 0.68-1.14). However, an inverse association with EOC risk was observed among women who had a tubal ligation at age 35 years or older (OR 0.64; 95% CI 0.41-0.98), but not among those who had a tubal ligation before age 35 (OR 0.98; 95% CI 0.74-1.29) (p for interaction = 0.08). The association also varied considerably by tumor subtype. A strong inverse association was observed for endometrioid tumors (OR 0.31, 95% CI 0.14-0.70), whereas associations with mucinous (OR 0.87, 95% CI 0.36-2.12) and serous (OR 0.94, 95% CI 0.71-1.24) tumors were weaker and not statistically significant. A statistically non-significant positive association for clear cell tumors (OR 1.84, 95% CI 0.58-5.82) was based on a low number of cases. CONCLUSIONS: Our findings show that tubal ligation may confer a reduced risk for EOC among AA women that is comparable to the associations that have been previously observed in primarily white populations.
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