Hormonal and reproductive factors and the risk of ovarian cancer

Purpose Hormone-related factors have been associated with ovarian cancer, the strongest being parity and oral contraceptive use. Given reductions in birth rates and increases in oral contraceptive use over time, associations in more recent birth cohorts may differ. Furthermore, consideration of ovarian cancer heterogeneity (i.e., Type I/II invasive cancers) may contribute to a better understanding of etiology. We examined hormone-related factors in relation to ovarian cancer risk overall, for Type I and Type II cancers, as well as borderline tumors.

A population-based case–control study was carried out in Montreal, Canada from 2011 to 2016, including 496 cases and 908 controls. For each hormone-related variable, adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression for ovarian cancer overall, and using polytomous logistic regression for associations by tumor behavior and ovarian cancer type.

Parity was inversely associated with risk overall and by tumor behavior and type, with a stronger OR (95% CI) for Type I [0.09 (0.04–0.24) for ≥3 full-term births vs. nulliparity] vs. Type II [0.66 (0.43–1.02)] invasive cancers; the OR (95% CI) for borderline tumors was 0.41 (0.22–0.77). Oral contraceptive ever use was not associated with risk overall, but ≥10 years of use vs. never use reduced risk, particularly for invasive cancers. A history of endometriosis was most strongly associated with Type I cancers. Associations with other factors were less clear.

These results suggest that associations with some hormone-related factors may differ between borderline and invasive Type I and II ovarian cancers. Similar content being viewed by others

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Epidemiology 15:615–625 Acknowledgments This research was supported by the Canadian Cancer Society (Grant #700485) and the Cancer Research Society, the Fonds de recherche du Québec-Santé, and the Ministère de l’Économie de la Science et de l’Innovation du Québec GRePEC program (Grant #16264). Dr. Koushik was supported by the Cancer Research Society-Cancer Guzzo Université de Montréal Award, the Fonds de recherche du Québec-Santé Research Scholar Program, and the Canadian Institutes of Health Research New Investigator program. Dr. Abrahamowicz is a James McGill Professor at McGill University. Dr. Siemiatycki holds the Guzzo-Cancer Research Society Chair in Environment and Cancer. The CRCHUM and the MUHC Research Institute receive support from the Fonds de recherche du Québec-Santé. We are grateful to our interviewers Claire Walker, Françoise Pineault, and Martine Le Comte, and to Ana Gueorguieva for data management. We also thank our additional clinical collaborators Drs. Suzanne Fortin, Dominique Tremblay and Michel Welt. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Koushik, A., Grundy, A., Abrahamowicz, M. et al. Hormonal and reproductive factors and the risk of ovarian cancer. Cancer Causes Control 28, 393–403 (2017). https://doi.org/10.1007/s10552-016-0848-9 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s10552-016-0848-9