Jeanine N Staples1, Lauren C Peres2, Fabian Camacho3, Anthony J Alberg4, Elisa V Bandera5, Jill Barnholtz-Sloan6, Melissa L Bondy7, Michele L Cote8, Ellen Funkhouser9, Patricia G Moorman10, Edward S Peters11, Ann G Schwartz8, Paul D Terry12, Joellen M Schildkraut13. 1. Division of Gynecology Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA. Electronic address: js6qf@hscmail.mcc.virginia.edu. 2. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA. 3. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA. 4. Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA. 5. Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA. 6. Department of Population and Quantitative Health Sciences and 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. Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA. 9. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 10. Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA. 11. Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA. 12. Department of Medicine, University of Tennessee Medical Center - Knoxville, Knoxville, TN, USA. 13. Emory University Rollins School of Public Health, Atlanta, GA, USA.
Abstract
BACKGROUND: Studies that have examined the association between cardiovascular comorbidities and epithelial ovarian cancer (EOC) have yielded inconsistent results. It remains unknown whether cardiometabolic disease is associated with EOC in African American (AA) women, who have a higher prevalence of cardiovascular disease and lower risk of EOC than White women. Here, we estimate the effect of cardiovascular comorbid conditions and EOC risk among AA women. METHODS: Data were available from 593 ovarian carcinoma patients and 752 controls enrolled in the African American Cancer Epidemiology Study (AACES). Participants were asked to self-report a history of hypertension, hyperlipidemia, and diabetes and any current medication use. The relationship between hypertension, hyperlipidemia, diabetes, and medications taken for these conditions was determined using multivariate logistic regression. RESULTS: Hypertension was associated with an increased risk (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.01, 1.73), whereas diabetes and hyperlipidemia were associated with a decreased risk (aOR = 0.67, 95% CI = 0.49, 0.91 and aOR = 0.61, 95% CI = 0.47, 0.80, respectively) of EOC. Use of anti-diabetic medication was inversely associated with EOC risk, as was use of lipid lowering medications (in the overall study population), which were predominantly statins. Among women with hypertension, use of anti-hypertensive medications was inversely associated with EOC risk, with associations that were most pronounced for diuretics, ARBs and ACE inhibitors. CONCLUSION: Hypertension was associated with an increased EOC risk in this patient population, whereas an inverse association was observed for diabetes and hyperlipidemia. The decreased risk of EOC identified with use of anti-hypertensive, anti-diabetes or lipid-lowering medications could have implications for risk reduction strategies.
BACKGROUND: Studies that have examined the association between cardiovascular comorbidities and epithelial ovarian cancer (EOC) have yielded inconsistent results. It remains unknown whether cardiometabolic disease is associated with EOC in African American (AA) women, who have a higher prevalence of cardiovascular disease and lower risk of EOC than White women. Here, we estimate the effect of cardiovascular comorbid conditions and EOC risk among AA women. METHODS: Data were available from 593 ovarian carcinoma patients and 752 controls enrolled in the African American Cancer Epidemiology Study (AACES). Participants were asked to self-report a history of hypertension, hyperlipidemia, and diabetes and any current medication use. The relationship between hypertension, hyperlipidemia, diabetes, and medications taken for these conditions was determined using multivariate logistic regression. RESULTS: Hypertension was associated with an increased risk (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.01, 1.73), whereas diabetes and hyperlipidemia were associated with a decreased risk (aOR = 0.67, 95% CI = 0.49, 0.91 and aOR = 0.61, 95% CI = 0.47, 0.80, respectively) of EOC. Use of anti-diabetic medication was inversely associated with EOC risk, as was use of lipid lowering medications (in the overall study population), which were predominantly statins. Among women with hypertension, use of anti-hypertensive medications was inversely associated with EOC risk, with associations that were most pronounced for diuretics, ARBs and ACE inhibitors. CONCLUSION: Hypertension was associated with an increased EOC risk in this patient population, whereas an inverse association was observed for diabetes and hyperlipidemia. The decreased risk of EOC identified with use of anti-hypertensive, anti-diabetes or lipid-lowering medications could have implications for risk reduction strategies.
Authors: Babatunde Akinwunmi; Allison F Vitonis; Linda Titus; Kathryn L Terry; Daniel W Cramer Journal: Int J Cancer Date: 2018-10-30 Impact factor: 7.396
Authors: Andrea L Buras; Tianyi Wang; Junmin Whiting; Mary K Townsend; Brooke L Fridley; Shelley S Tworoger Journal: Am J Epidemiol Date: 2022-05-20 Impact factor: 5.363