Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis.
Journal
Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089
Informations de publication
Date de publication:
08 05 2023
08 05 2023
Historique:
received:
27
06
2022
revised:
10
11
2022
accepted:
06
01
2023
medline:
9
5
2023
pubmed:
24
1
2023
entrez:
23
1
2023
Statut:
ppublish
Résumé
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. 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. 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. 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.
Sections du résumé
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.
Identifiants
pubmed: 36688720
pii: 6998214
doi: 10.1093/jnci/djad011
pmc: PMC10165492
mid: EMS189178
doi:
Substances chimiques
Contraceptives, Oral
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
539-551Subventions
Organisme : NIH HHS
ID : K05-CA154337
Pays : United States
Organisme : NIH HHS
ID : P01CA17054
Pays : United States
Organisme : NIH HHS
ID : R01-CA112523
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA015083
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA248288
Pays : United States
Organisme : NIH HHS
ID : R01-CA58598
Pays : United States
Organisme : Medical Research Council
ID : MC_UU_00004/01
Pays : United Kingdom
Organisme : NCI NIH HHS
ID : P50 CA136393
Pays : United States
Informations de copyright
© The Author(s) 2023. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
J Natl Cancer Inst. 1997 Jul 2;89(13):932-8
pubmed: 9214672
Nat Genet. 2009 Sep;41(9):996-1000
pubmed: 19648919
J Natl Cancer Inst. 1998 Nov 18;90(22):1729-34
pubmed: 9827528
Cancer Causes Control. 2012 Dec;23(12):1985-94
pubmed: 23065074
BMC Cancer. 2007 Apr 05;7:60
pubmed: 17411440
Gynecol Oncol. 2011 May 1;121(2):353-7
pubmed: 21324516
Epidemiology. 2012 Mar;23(2):311-9
pubmed: 22252409
Endocr Relat Cancer. 2008 Dec;15(4):1055-60
pubmed: 18667686
J Pathol. 2016 Dec;240(4):484-494
pubmed: 27625309
Cancer Causes Control. 2002 Nov;13(9):807-11
pubmed: 12462545
Fertil Steril. 2004 Jul;82(1):186-95
pubmed: 15237010
Int J Cancer. 2009 Mar 15;124(6):1409-15
pubmed: 19065661
J Natl Cancer Inst. 1999 Sep 1;91(17):1459-67
pubmed: 10469746
Am J Epidemiol. 2005 Feb 15;161(4):321-9
pubmed: 15692075
Am J Epidemiol. 2010 Jan 1;171(1):45-53
pubmed: 19910378
Am J Epidemiol. 2004 Oct 1;160(7):613-8
pubmed: 15383404
Cancer Epidemiol Biomarkers Prev. 2008 Mar;17(3):585-93
pubmed: 18349276
Int J Cancer. 2008 Jul 15;123(2):380-388
pubmed: 18431743
Am J Epidemiol. 2005 Dec 1;162(11):1123-31
pubmed: 16236996
Gynecol Oncol. 2022 Jun;165(3):650-663
pubmed: 35473671
Am J Epidemiol. 2016 May 1;183(9):800-14
pubmed: 27190045
Am J Epidemiol. 1981 Sep;114(3):398-405
pubmed: 7304575
J Natl Cancer Inst. 1983 Oct;71(4):717-21
pubmed: 6578367
Carcinogenesis. 2015 Nov;36(11):1419-28
pubmed: 26363031
Int J Gynecol Cancer. 2009 Jan;19(1):58-64
pubmed: 19258943
Am J Epidemiol. 1983 Feb;117(2):128-39
pubmed: 6681935
Gynecol Oncol. 2014 Feb;132(2):322-7
pubmed: 24355484
Lancet. 1971 Jul 17;2(7716):163
pubmed: 4104488
Cancer Causes Control. 2017 May;28(5):405-414
pubmed: 28251458
Int J Mol Sci. 2016 Dec 15;17(12):
pubmed: 27983698
Cancer Res. 1989 Jul 15;49(14):4047-52
pubmed: 2736545
Int J Cancer. 2001 Nov 20;95(6):370-4
pubmed: 11668519
Am J Epidemiol. 2002 Feb 1;155(3):217-24
pubmed: 11821246
J Natl Cancer Inst. 1998 Dec 2;90(23):1774-86
pubmed: 9839517
Am J Epidemiol. 1992 Nov 15;136(10):1175-83
pubmed: 1476140
Int J Cancer. 2003 Mar 20;104(2):228-32
pubmed: 12569579
Syst Biol. 2014 Mar;63(2):203-18
pubmed: 24335428
Contraception. 2012 Nov;86(5):494-9
pubmed: 22579106
JAMA Oncol. 2020 Jun 1;6(6):e200421
pubmed: 32239218
Cancer Res. 2020 Mar 1;80(5):1210-1218
pubmed: 31932455
PLoS One. 2010 Apr 08;5(4):e10061
pubmed: 20386703
Am J Surg Pathol. 2010 Mar;34(3):433-43
pubmed: 20154587
J Prev Med Public Health. 2016 Nov;49(6):349-366
pubmed: 27951628
Int J Cancer. 2017 Dec 15;141(12):2392-2399
pubmed: 28748634
Gynecol Oncol. 2003 Jan;88(1 Pt 2):S145-8
pubmed: 12586107
Ann Epidemiol. 2011 Jun;21(6):450-60
pubmed: 21441037
Epidemiology. 2005 Jul;16(4):508-15
pubmed: 15951669
EBioMedicine. 2019 Mar;41:597-609
pubmed: 30852161
J Soc Gynecol Investig. 1998 Sep-Oct;5(5):271-6
pubmed: 9773403
J Chronic Dis. 1987;40 Suppl 2:59S-69S
pubmed: 3667868
Am J Epidemiol. 1994 Oct 1;140(7):585-97
pubmed: 7942759
Am J Obstet Gynecol. 2007 Jan;196(1):83.e1-7
pubmed: 17240246
Asian Pac J Cancer Prev. 2001;2(2):99-107
pubmed: 12718640
Fam Cancer. 2012 Sep;11(3):343-9
pubmed: 22388872
Int J Epidemiol. 1983 Jun;12(2):161-4
pubmed: 6874210
Arch Med Res. 1995 Autumn;26(3):245-9
pubmed: 8580675
Cancer Epidemiol Biomarkers Prev. 2007 Jun;16(6):1160-6
pubmed: 17548679
Int J Cancer. 2008 Jan 1;122(1):170-6
pubmed: 17721999
Am J Epidemiol. 1988 Dec;128(6):1216-27
pubmed: 3195563
Diagnostics (Basel). 2020 Jan 19;10(1):
pubmed: 31963927
Cancers (Basel). 2021 Jan 26;13(3):
pubmed: 33530497
J Clin Oncol. 2016 Aug 20;34(24):2888-98
pubmed: 27325851
Cancer Epidemiol Biomarkers Prev. 2000 Jan;9(1):103-11
pubmed: 10667470
J Clin Epidemiol. 2011 May;64(5):525-30
pubmed: 21074968
Am J Epidemiol. 2004 Jan 1;159(1):83-93
pubmed: 14693663
Cancers (Basel). 2012 Jul 18;4(3):701-24
pubmed: 24213462
Cancer Res. 2008 Apr 1;68(7):2498-506
pubmed: 18381459
Cancer Epidemiol Biomarkers Prev. 2007 Jan;16(1):30-5
pubmed: 17220329
Am J Epidemiol. 1996 Aug 15;144(4):363-72
pubmed: 8712193
Kidney Int. 2007 Sep;72(5):632-7
pubmed: 17568781
Am J Epidemiol. 2003 Oct 1;158(7):629-38
pubmed: 14507598
IARC Sci Publ. 2002;156:69-70
pubmed: 12484128
Cancers (Basel). 2018 Nov 12;10(11):
pubmed: 30424539
Cancer Res. 2005 Jul 1;65(13):5974-81
pubmed: 15994977
Cancer. 2005 Dec 15;104(12):2807-16
pubmed: 16284991
BMC Womens Health. 2011 Sep 23;11:40
pubmed: 21943063
Cancer Epidemiol Biomarkers Prev. 2006 Sep;15(9):1738-41
pubmed: 16985038