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Multiple Miscarriages Are Associated with the Risk of Ovarian Cancer: Results from the European Prospective Investigation into Cancer and Nutrition

Braem, Marieke G. M.; Onland-Moret, N. Charlotte; Schouten, Leo J.; Kruitwagen, Roy F. P. M.; Lukanova, Annekatrin; Allen, Naomi E.; Wark, Petra A.; Tjonneland, Anne; Hansen, Louise and Brauner, Christina Marie, et al. (2012) In PLoS ONE 7(5).
Abstract
While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall... (More)
While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR >= 4vs.0: 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR >= 4vs.0: 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR >= 4vs.0: 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories. (Less)
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PLoS ONE
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7
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5
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Public Library of Science
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  • wos:000305343500064
  • scopus:84862092293
ISSN
1932-6203
DOI
10.1371/journal.pone.0037141
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English
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5e1ed54e-b06f-473b-a353-1d8ab5ce3e83 (old id 2890710)
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@article{5e1ed54e-b06f-473b-a353-1d8ab5ce3e83,
  abstract     = {While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR >= 4vs.0: 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR >= 4vs.0: 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR >= 4vs.0: 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories.},
  author       = {Braem, Marieke G. M. and Onland-Moret, N. Charlotte and Schouten, Leo J. and Kruitwagen, Roy F. P. M. and Lukanova, Annekatrin and Allen, Naomi E. and Wark, Petra A. and Tjonneland, Anne and Hansen, Louise and Brauner, Christina Marie and Overvad, Kim and Clavel-Chapelon, Francoise and Chabbert-Buffet, Nathalie and Teucher, Birgit and Floegel, Anna and Boeing, Heiner and Trichopoulou, Antonia and Adarakis, George and Plada, Maria and Rinaldi, Sabina and Fedirko, Veronika and Romieu, Isabelle and Pala, Valeria and Galasso, Rocco and Sacerdote, Carlotta and Palli, Domenico and Tumino, Rosario and Bueno-de-Mesquita, H. Bas and Gram, Inger Torhild and Gavrilyuk, Oxana and Lund, Eiliv and Sanchez, Maria-Jose and Bonet, Catalina and Chirlaque, Maria-Dolores and Larranaga, Nerea and Barricarte Gurrea, Aurelio and Quiros, Jose R. and Idahl, Annika and Ohlson, Nina and Lundin, Eva and Jirström, Karin and Butt, Salma and Tsilidis, Konstantinos K. and Khaw, Kay-Tee and Wareham, Nick and Riboli, Elio and Kaaks, Rudolf and Peeters, Petra H. M.},
  issn         = {1932-6203},
  language     = {eng},
  number       = {5},
  publisher    = {Public Library of Science},
  series       = {PLoS ONE},
  title        = {Multiple Miscarriages Are Associated with the Risk of Ovarian Cancer: Results from the European Prospective Investigation into Cancer and Nutrition},
  url          = {http://dx.doi.org/10.1371/journal.pone.0037141},
  volume       = {7},
  year         = {2012},
}