Hormonal factors and the risk of invasive ovarian cancer: a population-based case-control study

Pike, Malcolm C; Pearce, Celeste L; Peters, Ruth; Cozen, Wendy; Wan, Peggy; Wu, Anna H

doi:10.1016/j.fertnstert.2004.03.013

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Volume 82, Issue 1 , Pages 186-195, July 2004

Hormonal factors and the risk of invasive ovarian cancer: a population-based case-control study☆☆☆

Malcolm C Pike, Ph.D.
- USC/Norris Comprehensive Cancer Center, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
- Reprint requests: Malcolm C. Pike, Ph.D., USC/Norris Comprehensive Cancer Center, 1441 Eastlake Avenue, NOR4436, Los Angeles, California 90033, USA (FAX: 323-865-0125).
Celeste L Pearce, Ph.D.
- USC/Norris Comprehensive Cancer Center, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
Ruth Peters, D.Sc.
- USC/Norris Comprehensive Cancer Center, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
Wendy Cozen, D.O.
- USC/Norris Comprehensive Cancer Center, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
Peggy Wan, M.S.
- USC/Norris Comprehensive Cancer Center, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA
Anna H Wu, Ph.D.
- USC/Norris Comprehensive Cancer Center, Keck School of Medicine, Department of Preventive Medicine, University of Southern California, Los Angeles, California, USA

Received 23 September 2003; received in revised form 9 March 2004; accepted 9 March 2004.

Abstract

Objective

To examine the influence of hormone-related factors on the risk of invasive epithelial ovarian cancer (ovarian cancer).

Design

Population-based case–control study using in-person interviews.

Setting

Academic department of preventive medicine.

Patient(s)

Four hundred seventy-seven ovarian cancer patients and 660 controls.

Intervention(s)

None.

Main outcome measure(s)

Numbers of and ages at births, oral contraceptive use, and use of menopausal hormone therapy.

Result(s)

Compared with nulliparous women, women whose only (last) birth was after age 35 years had an estimated 51% (95% confidence interval: 21%–70%) reduction in risk. If this birth occurred earlier, the reduction in risk was progressively less. Additional (earlier) births reduced the risk further. Oral contraceptive use also reduced risk. Increased body mass index increased risk, but this effect was confined to localized disease and is likely to be a diagnostic bias, as a consequence of other problems associated with being overweight and in itself having no etiological significance.

Conclusion(s)

If the major protective effect of a late birth can be confirmed, our most challenging task will be to understand the mechanism to develop a chemoprevention approach to exploit this finding.

Keywords: Ovarian cancer, parity, estrogen therapy, oral contraceptives

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☆ Supported by Public Health Service (Bethesda, MD) grants CA 17054, CA 14089, CA 61132, and N01-PC-67010 (National Cancer Institute) and by subcontract 050-E8709 from the California Public Health Institute (Oakland, CA), which is supported by the California Department of Health Services as part of its statewide cancer reporting program mandated by Health and Safety Code Sections 210 and 211.3.

☆☆ The ideas and opinions expressed herein are those of the authors, and no endorsement by the State of California or the California Public Health Foundation is intended or should be inferred.

PII: S0015-0282(04)00556-4

doi:10.1016/j.fertnstert.2004.03.013