American Journal of Epidemiology Vol. 140, No. 7: 585-597
Copyright © 1994 by The Johns Hopkins University School of Hygiene and Public Health
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Parity, Contraception, Infertility, and the Risk of Epithelial Ovarian Cancer
1Department of Epidemiology and Public Health, Yale University School of Medicine New Haven, CT
2Ontario Cancer Treatment and Research Foundation Toronto, Ontario, Canada
3NCIC Epidemiology Unit, Department of Preven tive Medicine and Biostatistics, University of Toronto Toronto, Ontario, Canada
Reprint requests to Dr. Harvey A. Risch, Department of Epidemiology and Public Health, Yale University School of Medicine, 60 College Street, P.O. Box 3333, New Haven, CT 06510
A case-control study of reproductive factors and cancer of the ovary was conducted during 1989-1992 in metropolitan Toronto and nearby areas of Southern Ontario, Canada. In total, 450 women aged 35–79 years with histologically verified new primary epithelial ovarian cancers were interviewed concerning their reproductive histories. Over the same time period, 564 randomly selected population controls, frequency-matched to the cases according to three 15-year age groups, were also interviewed. Continuous unconditional logistic regression methods were used for analysis. It was found that childbearing and use of oral contraceptives were associ ated with significant decreasing trends in risk of ovarian cancer; the respective odds ratios were 0.78 for each full-term pregnancy (p < 10–8) and 0.92 for each year of use (p < 10–6). Hysterectomy was also associated with reduced risk, even after more than 20 years. Among parous women, infertility did not appear to affect risk; for nulliparous women, some evidence of increased risk was present, although fertility problems were reported by only a small fraction of nulliparae. It is suggested that the relatively lower parity of cases as compared with controls may be due to voluntary choices for having fewer children.
contraception; infertility; ovarian neoplasms; parity; pregnancy; reproduction; retrospective studies
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