Factors related to inflammation of the ovarian epithelium and risk of ovarian cancer
Ness RB,
R. B. Ness,
Grisso JA,
J A Grisso,
Cottreau C,
C Cottreau,
J Klapper,
Klapper J,
Vergona R,
R Vergona,
Wheeler JE,
J E Wheeler,
Morgan M,
M Morgan,
Schlesselman JJ,
J J Schlesselman
Observational
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A case-control study found that factors suppressing ovulation and gynecologic surgery reduce ovarian cancer risk, while endometriosis, talc use, cysts, and hyperthyroidism increase it, supporting the hypothesis that inflammation mediates this risk.
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This case-control study evaluated the association between various reproductive, environmental, and medical factors and the risk of epithelial ovarian cancer to test the hypothesis that inflammation mediates this risk. The researchers compared 767 women with recent ovarian cancer diagnoses against 1367 community controls, analyzing variables such as ovulation suppression, talc use, and prior gynecologic surgeries. Key findings indicated that factors suppressing ovulation like oral contraception and breastfeeding reduced risk, while conditions potentially linked to inflammation, including endometriosis, ovarian cysts, and perineal talc use, increased it. Protective effects were also observed for hysterectomy and tubal ligation, supporting the role of inflammatory processes in carcinogenesis. Relevance to endometriosis: listed as one factor associated with increased risk of ovarian cancer due to its potential to induce inflammatory responses in the ovarian epithelium.
Abstract
Previous epidemiologic observations consistently suggest that suppression of ovulation, tubal ligation, and hysterectomy reduce the risk of ovarian cancer and that perineal talc use increases the risk. We examined these and other risk factors in the context of a new hypothesis: that inflammation may play a role in ovarian cancer risk. Ovulation entails ovarian epithelial inflammation; talc, endometriosis, cysts, and hyperthyroidism may be associated with inflammatory responses of the ovarian epithelium; gynecologic surgery may preclude irritants from reaching the ovaries via ascension from the lower genital tract. We evaluated these risk factors in a population-based case-control study. Cases 20-69 years of age with a recent diagnosis of epithelial ovarian cancer (767) were compared with community controls (1,367). We found that a number of reproductive and contraceptive factors that suppress ovulation, including gravidity, breast feeding, and oral contraception, reduced the risk of ovarian cancer. Environmental factors and medical conditions that increased risk included talc use, endometriosis, ovarian cysts, and hyperthyroidism. Gynecologic surgery including hysterectomy and tubal ligation were protective. Tubal ligation afforded a risk reduction even 20 or more years after the surgery. The spectrum of associations provides support for the hypothesis that inflammation may mediate ovarian cancer risk.
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Factors Related to Inflammation of the Ovarian Epithelium and Risk of Ovarian Cancer
- Roberta B. Ness
- Jeane Ann Grisso
- Carrie Cottreau
- Jennifer Klapper
- Ron Vergona
- James E. Wheeler
- Mark Morgan
- James J. Schlesselman
Previous epidemiologic observations consistently suggest that suppression of ovulation, tubal ligation, and hysterectomy reduce the risk of ovarian cancer and that perineal talc use increases the risk. We examined these and other risk factors in the context of a new hypothesis: that inflammation may play a role in ovarian cancer risk. Ovulation entails ovarian epithelial inflammation; talc, endometriosis, cysts, and hyperthyroidism may be associated with inflammatory responses of the ovarian epithelium; gynecologic surgery may preclude irritants from reaching the ovaries via ascension from the lower genital tract. We evaluated these risk factors in a population-based case-control study. Cases 20–69 years of age with a recent diagnosis of epithelial ovarian cancer (767) were compared with community controls (1367). We found that a number of reproductive and contraceptive factors that suppress ovulation, including gravidity, breast feeding, and oral contraception, reduced the risk of ovarian cancer. Environmental factors and medical conditions that increased risk included talc use, endometriosis, ovarian cysts, and hyperthyroidism. Gynecologic surgery including hysterectomy and tubal ligation were protective. Tubal ligation afforded a risk reduction even 20 or more years after the surgery. The spectrum of associations provides support for the hypothesis that inflammation may mediate ovarian cancer risk.
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Condition tags
endometriosis
MeSH descriptors
Carcinoma
Contraceptives, Oral
Endometriosis
Ovarian Neoplasms
Ovulation
Adult
Adult
Aged
Aged
Breast Feeding
Breast Feeding
Carcinoma
Carcinoma
Carcinoma
Case-Control Studies
Case-Control Studies
Centers for Medicare and Medicaid Services, U.S.
Centers for Medicare and Medicaid Services, U.S.
Contraceptives, Oral
Contraceptives, Oral
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- europepmc
- last seen: 2026-10-17T06:09:56.316927+00:00
- pubmed
- last seen: 2026-10-08T20:59:38.477535+00:00
- unpaywall
- last seen: 2026-10-17T06:24:38.187582+00:00
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