Effects of risk factors for ovarian cancer in women with and without endometriosis
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Objective: To evaluate the associations between 10 well-established ovarian cancer risk factors and risk of ovarian cancer among women with vs. without endometriosis. Design: Pooled analysis of 9 case-control studies in the Ovarian Cancer Association Consortium. Setting: Population-based. Patient(s): We included 8,500 women with ovarian cancer, 13,592 control women. Intervention(s): Ten well-established ovarian cancer risk factors. Main Outcome Measure(s): Risk of ovarian cancer for women with and without endometriosis. Result(s): Most risk factor-ovarian cancer associations were similar when comparing women with and without endometriosis, and no interactions were statistically significant. However, body mass index (BMI) 25–<30 kg/m2 was associated with increased ovarian cancer risk among women with endometriosis (odds ratio [OR] = 1.27, 95% confidence interval [CI] 1.00–1.60), but not associated with the risk among women without endometriosis (OR = 0.97; 95% CI, 0.91–1.05) when compared with BMI 18.5–<25 kg/m2; an increased risk was observed for a BMI ≥30 kg/m2, although there was little difference comparing women with endometriosis (OR = 1.21; 95% CI, 0.94–1.57) to women without (OR = 1.13; 95% CI, 1.04–1.22) (P-interaction = .51). Genital talcum powder use and long-term menopausal estrogen-only therapy use showed increased ovarian cancer risk, but risk appeared greater for those with endometriosis vs. those without (genital talcum powder: OR = 1.38; 95% CI, 1.04–1.84 vs. OR = 1.12; 95% CI, 1.01–1.25, respectively; ≥10 years of estrogen-only therapy: OR = 1.88; 95% CI, 1.09–3.24 vs. OR = 1.42; 95% CI, 1.14–1.76, respectively); neither of these interactions were statistically significant (P-interaction = .65 and P-interaction = .96, respectively). Conclusion(s): The associations between ovarian cancer and most risk factors were similar among women with and without endometriosis. However, there was some suggestion of differences by endometriosis status for BMI, menopausal hormone therapy use, and genital talcum powder use, highlighting the complexity of ovarian cancer etiology.
| Originalsprog | Engelsk |
|---|---|
| Tidsskrift | Fertility and Sterility |
| Vol/bind | 118 |
| Udgave nummer | 5 |
| Sider (fra-til) | 960-969 |
| Antal sider | 10 |
| ISSN | 0015-0282 |
| DOI | |
| Status | Udgivet - 2022 |
Bibliografisk note
Funding Information:
The Ovarian Cancer Association Consortium (OCAC) was funded by the generous contributions of its research investigators. It was also supported in part by the National Cancer Institute in Bethesda, US GAME-ON Post-GWAS Initiative (U19-CA148112). This study made use of data generated by the Wellcome Trust Case Control consortium that was supported by the Wellcome Trust in London, UK (award 076113). The AUS study was supported by the Army Medical Research and Materiel Command Department of Defense in Fort Detrick, US (DAMD17-01-1-0729), National Health & Medical Research Council in Canberra, Australia (199600, 400413, 400281), Cancer Councils of New South Wales, Victoria, Queensland, South Australia, and Tasmania and Cancer Foundation of Western Australia (Multi-State Applications 191, 21, 182). The AUS study was also supported by Ovarian Cancer Australia in Melbourne, Australia and the Peter MacCallum Foundation in Melbourne, Australia. P.M.W. was supported by an Investigator Grant from the National Health & Medical Research Council in Canberra, Australia (APP1173346). The CON study was supported by the National Institutes of Health in Bethesda, US (R01-CA063678, R01-CA074850, R01-CA080742). The DOV study was supported by the National Institutes of Health in Bethesda, US (R01-CA112523, R01-CA87538). The HAW study was supported by the National Institutes of Health in Bethesda, US (R01-CA58598, N01-CN55424, N01-PC67001). The HOP study was supported by the Army Medical Research and Materiel Command Department of Defense in Fort Detrick, US (DAMD17-02-1-0669), the National Cancer Institute in Bethesda, US (K07-CA080668, R01-CA95023), and the National Institutes of Health/National Center for Research Resources/General Clinical Research Center in Bethesda, US (M01-RR000056). The MAL study was supported by the National Cancer Institute at the National Institutes for Health in Bethesda, US (R01-CA61107), the Danish Cancer Society in Copenhagen, Denmark (94 222 52), and the Mermaid I and III projects in Copenhagen, Denmark. The NEC study was supported by the National Institutes of Health in Bethesda, US (R01-CA54419, P50-CA105009), and the Army Medical Research and Materiel Command Department of Defense in Fort Detrick, US (W81XWH-10-1-02802). The UCI study was supported by the National Institutes of Health in Bethesda, US (R01-CA058860) and the Lon V Smith Foundation in Beverly Hills, US (LVS-39420). The USC study was supported by the National Institutes of Health in Bethesda, US (P01-CA17054, P30-CA14089, R01-CA61132, N01-PC67010, R03-CA113148, R03-CA115195, N01-CN025403) and the California Cancer Research Program in the US (00-01389V-20170, 2II0200). M.C.P. was partially supported by the National Institutes of Health/National Cancer Institute support grant to Memorial Sloan Kettering Cancer Center (PI: C.B. Thompson) (P30-CA008748). B.T. was partially supported in part by the National Institutes of Health/National Cancer Institute support grant to the Huntsman Cancer Institute (P30-CA040214).
Funding Information:
The Ovarian Cancer Association Consortium (OCAC) was funded by the generous contributions of its research investigators. It was also supported in part by the National Cancer Institute in Bethesda, US GAME-ON Post-GWAS Initiative (U19-CA148112). This study made use of data generated by the Wellcome Trust Case Control consortium that was supported by the Wellcome Trust in London, UK (award 076113). The AUS study was supported by the Army Medical Research and Materiel Command Department of Defense in Fort Detrick, US (DAMD17-01-1-0729), National Health & Medical Research Council in Canberra, Australia (199600, 400413, 400281), Cancer Councils of New South Wales, Victoria, Queensland, South Australia, and Tasmania and Cancer Foundation of Western Australia (Multi-State Applications 191, 21, 182). The AUS study was also supported by Ovarian Cancer Australia in Melbourne, Australia and the Peter MacCallum Foundation in Melbourne, Australia. P.M.W. was supported by an Investigator Grant from the National Health & Medical Research Council in Canberra, Australia (APP1173346). The CON study was supported by the National Institutes of Health in Bethesda, US (R01-CA063678, R01-CA074850, R01-CA080742). The DOV study was supported by the National Institutes of Health in Bethesda, US (R01-CA112523, R01-CA87538). The HAW study was supported by the National Institutes of Health in Bethesda, US (R01-CA58598, N01-CN55424, N01-PC67001). The HOP study was supported by the Army Medical Research and Materiel Command Department of Defense in Fort Detrick, US (DAMD17-02-1-0669), the National Cancer Institute in Bethesda, US (K07-CA080668, R01-CA95023), and the National Institutes of Health/National Center for Research Resources/General Clinical Research Center in Bethesda, US (M01-RR000056). The MAL study was supported by the National Cancer Institute at the National Institutes for Health in Bethesda, US (R01-CA61107), the Danish Cancer Society in Copenhagen, Denmark (94 222 52), and the Mermaid I and III projects in Copenhagen, Denmark. The NEC study was supported by the National Institutes of Health in Bethesda, US (R01-CA54419, P50-CA105009), and the Army Medical Research and Materiel Command Department of Defense in Fort Detrick, US (W81XWH-10-1-02802). The UCI study was supported by the National Institutes of Health in Bethesda, US (R01-CA058860) and the Lon V Smith Foundation in Beverly Hills, US (LVS-39420). The USC study was supported by the National Institutes of Health in Bethesda, US (P01-CA17054, P30-CA14089, R01-CA61132, N01-PC67010, R03-CA113148, R03-CA115195, N01-CN025403) and the California Cancer Research Program in the US (00-01389V-20170, 2II0200). M.C.P. was partially supported by the National Institutes of Health/National Cancer Institute support grant to Memorial Sloan Kettering Cancer Center (PI: C.B. Thompson) (P30-CA008748). B.T. was partially supported in part by the National Institutes of Health/National Cancer Institute support grant to the Huntsman Cancer Institute (P30-CA040214). M.T.P. has nothing to disclose. A.M. reports consulting fees paid to their institution from AstraZeneca and Pfizer as well as reports stock and stock options ownership of Clovis Oncology. B.T. has nothing to disclose. P.M.W. reports grant funding to their institution from AstraZeneca, US Army Medical Research and Materiel Command, National Health and Medical Research Council of Australia, Cancer Councils of New South Wales, Victoria, Queensland, South Australia, and Tasmania and Cancer Foundation of Western Australia as well as receipt of a speaker's fee from AstraZeneca. S.J.J. has nothing to disclose. K.L.T. has nothing to disclose. D.W.C. reports payment for expert testimony from Ferraro Law Firm and Ashcraft and Gerel Law Firm and grant funding to their institution from the National Institutes of Health. L.J.T. reports grant funding to their institution from the National Cancer Institute. H.A.R. has nothing to disclose. J.A.D. has nothing to disclose. H.R.H. has nothing to disclose. M.T.G. has nothing to disclose. F.M. reports receipt of grants to their institution from the National Cancer Institute, the Department of Defense, and the Deans Faculty Advancement Fund and National Science Foundation. K.B.M. has nothing to disclose. A.J. has nothing to disclose. S.K.K. reports grant funding to their institution from Mermaid Project (Mermaid 3). H.A. has nothing to disclose. A.Z. has nothing to disclose. A.B. has nothing to disclose. L.K. has nothing to disclose. A.H.W. has nothing to disclose. M.C.P reports grant funding to their institution from the National Cancer Institute and the Department of Defense. C.L.P. reports grant funding to their institution from the National Institutes of Health and the Department of Defense; receipt of reimbursements for travel expenses from the Canadian Conference on Ovarian Cancer Research; declining an honorarium for participation on an advisory board for the Ovarian Cancer Research Alliance; and no payment received for a leadership role in the Ovarian Cancer Association Consortium. A.W.L. reports grant funding to their institution from the Rivkin Center for Ovarian Cancer.
Funding Information:
M.T.P. has nothing to disclose. A.M. reports consulting fees paid to their institution from AstraZeneca and Pfizer as well as reports stock and stock options ownership of Clovis Oncology. B.T. has nothing to disclose. P.M.W. reports grant funding to their institution from AstraZeneca, US Army Medical Research and Materiel Command, National Health and Medical Research Council of Australia, Cancer Councils of New South Wales, Victoria, Queensland, South Australia, and Tasmania and Cancer Foundation of Western Australia as well as receipt of a speaker’s fee from AstraZeneca. S.J.J. has nothing to disclose. K.L.T. has nothing to disclose. D.W.C. reports payment for expert testimony from Ferraro Law Firm and Ashcraft and Gerel Law Firm and grant funding to their institution from the National Institutes of Health. L.J.T. reports grant funding to their institution from the National Cancer Institute. H.A.R. has nothing to disclose. J.A.D. has nothing to disclose. H.R.H. has nothing to disclose. M.T.G. has nothing to disclose. F.M. reports receipt of grants to their institution from the National Cancer Institute, the Department of Defense, and the Deans Faculty Advancement Fund and National Science Foundation. K.B.M. has nothing to disclose. A.J. has nothing to disclose. S.K.K. reports grant funding to their institution from Mermaid Project (Mermaid 3). H.A. has nothing to disclose. A.Z. has nothing to disclose. A.B. has nothing to disclose. L.K. has nothing to disclose. A.H.W. has nothing to disclose. M.C.P reports grant funding to their institution from the National Cancer Institute and the Department of Defense. C.L.P. reports grant funding to their institution from the National Institutes of Health and the Department of Defense; receipt of reimbursements for travel expenses from the Canadian Conference on Ovarian Cancer Research; declining an honorarium for participation on an advisory board for the Ovarian Cancer Research Alliance; and no payment received for a leadership role in the Ovarian Cancer Association Consortium. A.W.L. reports grant funding to their institution from the Rivkin Center for Ovarian Cancer.
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