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Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition

Tsilidis, K. K.; Allen, N. E.; Key, T. J.; Dossus, L.; Lukanova, A.; Bakken, K.; Lund, E.; Fournier, A.; Overvad, K. and Hansen, L., et al. (2011) In British Journal of Cancer 105(9). p.1436-1442
Abstract
BACKGROUND: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. METHODS: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at... (More)
BACKGROUND: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. METHODS: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. RESULTS: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, <0.01). Compared with nulliparous women, parous women had a 29% (HR, 0.71; 95% CI, 0.59-0.87) lower risk, with an 8% reduction in risk for each additional pregnancy. A high age at menopause was associated with a higher risk of ovarian cancer (>52 vs <= 45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. CONCLUSION: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors. British Journal of Cancer (2011) 105, 1436-1442. doi:10.1038/bjc.2011.371 www.bjcancer.com Published online 13 September 2011 (C) 2011 Cancer Research UK (Less)
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published
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keywords
reproductive history, oral contraceptive use, ovarian cancer, cohort, study
in
British Journal of Cancer
volume
105
issue
9
pages
1436 - 1442
publisher
Nature Publishing Group
external identifiers
  • wos:000296282000028
  • scopus:80055013415
ISSN
1532-1827
DOI
10.1038/bjc.2011.371
language
English
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yes
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5c713eb8-fb23-43dd-9d98-ace261f1d4a0 (old id 2207970)
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2011-12-01 08:30:24
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2017-09-10 03:09:05
@article{5c713eb8-fb23-43dd-9d98-ace261f1d4a0,
  abstract     = {BACKGROUND: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. METHODS: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. RESULTS: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, &lt;0.01). Compared with nulliparous women, parous women had a 29% (HR, 0.71; 95% CI, 0.59-0.87) lower risk, with an 8% reduction in risk for each additional pregnancy. A high age at menopause was associated with a higher risk of ovarian cancer (&gt;52 vs &lt;= 45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. CONCLUSION: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors. British Journal of Cancer (2011) 105, 1436-1442. doi:10.1038/bjc.2011.371 www.bjcancer.com Published online 13 September 2011 (C) 2011 Cancer Research UK},
  author       = {Tsilidis, K. K. and Allen, N. E. and Key, T. J. and Dossus, L. and Lukanova, A. and Bakken, K. and Lund, E. and Fournier, A. and Overvad, K. and Hansen, L. and Tjonneland, A. and Fedirko, V. and Rinaldi, S. and Romieu, I. and Clavel-Chapelon, F. and Engel, P. and Kaaks, R. and Schuetze, M. and Steffen, A. and Bamia, C. and Trichopoulou, A. and Zylis, D. and Masala, G. and Pala, V. and Galasso, R. and Tumino, R. and Sacerdote, C. and Bueno-de-Mesquita, H. B. and van Duijnhoven, F. J. B. and Braem, M. G. M. and Onland-Moret, N. C. and Gram, I. T. and Rodriguez, L. and Travier, N. and Sanchez, M-J and Huerta, J. M. and Ardanaz, E. and Larranaga, N. and Jirström, Karin and Manjer, Jonas and Idahl, A. and Ohlson, N. and Khaw, K-T and Wareham, N. and Mouw, T. and Norat, T. and Riboli, E.},
  issn         = {1532-1827},
  keyword      = {reproductive history,oral contraceptive use,ovarian cancer,cohort,study},
  language     = {eng},
  number       = {9},
  pages        = {1436--1442},
  publisher    = {Nature Publishing Group},
  series       = {British Journal of Cancer},
  title        = {Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1038/bjc.2011.371},
  volume       = {105},
  year         = {2011},
}