Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis

Fu, Z; Brooks, MM; Irvin, S; Jordan, S; Aben, KKH; Anton-Culver, H; Bandera, EV; Beckmann, MW; Berchuck, A; Brooks-Wilson, A; Chang-Claude, J; Cook, LS; Cramer, DW; Cushing-Haugen, KL; Doherty, JA; Ekici, AB; Fasching, PA; Fortner, RT; Gayther, SA; Gentry-Maharaj, A; Giles, GG; Goode, EL; Goodman, MT; Harris, HR; Hein, A; Kaaks, R; Kiemeney, LA; Kobel, M; Kotsopoulos, J; Le, ND; Lee, AW; Matsuo, K; McGuire, V; McLaughlin, JR; Menon, U; Milne, RL; Moysich, KB; Pearce, CL; Pike, MC; Qin, B; Ramus, SJ; Riggan, MJ; Rothstein, JH; Schildkraut, JM; Sieh, W; Sutphen, R; Terry, KL; Thompson, PJ; Titus, L; van Altena, AM; White, E; Whittemore, AS; Wu, AH; Zheng, W; Ziogas, A; Taylor, SE; Tang, L; Songer, T; Wentzensen, N; Webb, PM; AOCS Group; Risch, HA; Modugno, F; Ovarian Cancer Association; Consortium

Author(s): Fu, Z; Brooks, MM; Irvin, S; Jordan, S; Aben, KKH; Anton-Culver, H; Bandera, EV; Beckmann, MW; Berchuck, A; Brooks-Wilson, A; Chang-Claude, J; Cook, LS; Cramer, DW; Cushing-Haugen, KL; Doherty, JA; Ekici, AB; Fasching, PA; Fortner, RT; Gayther, SA; Gentry-Maharaj, A; Giles, GG; Goode, EL; Goodman, MT; Harris, HR; Hein, A; Kaaks, R; Kiemeney, LA; Kobel, M; Kotsopoulos, J; Le, ND; Lee, AW; Matsuo, K; McGuire, V; McLaughlin, JR; Menon, U; Milne, RL; Moysich, KB; Pearce, CL; Pike, MC; Qin, B; Ramus, SJ; Riggan, MJ; Rothstein, JH; Schildkraut, JM; Sieh, W; Sutphen, R; Terry, KL; Thompson, PJ; Titus, L; van Altena, AM; White, E; Whittemore, AS; Wu, AH; Zheng, W; Ziogas, A; Taylor, SE; Tang, L; Songer, T; Wentzensen, N; Webb, PM; AOCS Group; Risch, HA; Modugno, F; Ovarian Cancer Association; Consortium;
Details: Publication Year 2023,Volume 115,Issue #5,Page 539-551
Journal Title: Journal of the National Cancer Institute
Publication Type: Research article
Abstract: BACKGROUND: The role of ovulation in epithelial ovarian cancer (EOC) is supported by the consistent protective effects of parity and oral contraceptive use. Whether these factors protect through anovulation alone remains unclear. We explored the association between lifetime ovulatory years (LOY) and EOC. METHODS: LOY was calculated using 12 algorithms. Odds ratios (ORs) and 95% confidence intervals (CIs) estimated the association between LOY or LOY components and EOC among 26 204 control participants and 21 267 case patients from 25 studies. To assess whether LOY components act through ovulation suppression alone, we compared beta coefficients obtained from regression models with expected estimates assuming 1 year of ovulation suppression has the same effect regardless of source. RESULTS: LOY was associated with increased EOC risk (OR per year increase = 1.014, 95% CI = 1.009 to 1.020 to OR per year increase = 1.044, 95% CI = 1.041 to 1.048). Individual LOY components, except age at menarche, also associated with EOC. The estimated model coefficient for oral contraceptive use and pregnancies were 4.45 times and 12- to 15-fold greater than expected, respectively. LOY was associated with high-grade serous, low-grade serous, endometrioid, and clear cell histotypes (ORs per year increase = 1.054, 1.040, 1.065, and 1.098, respectively) but not mucinous tumors. Estimated coefficients of LOY components were close to expected estimates for high-grade serous but larger than expected for low-grade serous, endometrioid, and clear cell histotypes. CONCLUSIONS: LOY is positively associated with nonmucinous EOC. Differences between estimated and expected model coefficients for LOY components suggest factors beyond ovulation underlie the associations between LOY components and EOC in general and for non-HGSOC.
Keywords: Pregnancy; Humans; Female; Carcinoma, Ovarian Epithelial/epidemiology; *Ovarian Neoplasms/epidemiology/etiology/pathology; Risk Factors; Parity; Contraceptives, Oral/adverse effects; Case-Control Studies
Department(s): Laboratory Research
PubMed ID: 36688720
Publisher's Version: https://doi.org/10.1093/jnci/djad011
Terms of Use/Rights Notice: Refer to copyright notice on published article.

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