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American Journal of Epidemiology Vol. 136, No. 10: 1184-1203
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
research-article |
Characteristics Relating to Ovarian Cancer Risk: Collaborative Analysis of 12 US Case -Control Studies
II. Invasive Epithelial Ovarian Cancers in White Women
1Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine Stanford, CA.
2Members of the Collaborative Ovarian Cancer Group: Dr. John T. Casagrande, Department of Preventive Medicine, University of Southern California, Los Angeles, CA; Dr. Daniel Cramer, Department of Obstetrics and Gynecotogy, Brigham and Women's Hospital, Boston, MA; Dr. Patricia Hartge, Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD; Dr Jennifer L. Keteey, Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; Dr. Manon Lee, Department of Epidemiology, University of California, San Francisco, San Francisco, CA; Dr. Nancy C. Lee, Women's Health and FertJity Branch, Division of Reproductive Health, Centers for Disease Control, Atlanta, GA; Dr. Joseph L. Lyon, Department of Family and Community Medicine, The University of Utah Medical Center, Salt Lake City, UT; Dr. James R. Marshall, Department of Social and Preventive Medicine, State University of New York at Buffalo School of Medicine, Buffalo, NY; Dr. Larry McGowan, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, George Washington University Medical Center, Washington, DC; Dr. Philip C. Nasca, New York State Department of Health, Bureau of Cancer Epidemiology, School of Public Health, Department of Epidemiology, Albany, NY; Dr. Ralph S.Paffenbarger, Jr., Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA; Dr. Lynn Rosenberg, Stone Epidemiology Unit, School of Pubic Health, Boston University School of Medicine, Brookline, MA; and Dr. Noel S. Weiss, Department of Epidemiology, School of Public Health and Community Medicine, University of Washington, eattle, WA. Project Consultant: Dr. Genrose D. Copley, Extramural Programs, Division of Cancer Etiology, National Cancer Institute, Bethesda, MD.
Reprint requests to Dr. Alice S. Whittemore, Stanford University School of Medicine, Department of Health Research and Policy, HRP Modular no. 2, Stanford, CA 94305–5092.
Data collected from 2,197 white ovarian cancer patients and 8,893 white controls in 12 US case-control studies conducted in the period 1956–1986 were used to evaluate the relation of invasive epithelial ovarian cancer to reproductive and menstrual characteristics, exogenous estrogen use, and prior pelvic surgeries. Clear trends of decreasing risk were evident with increasing number of pregnancies (regardless of outcome) and increasing duration of breast feeding and oral contraceptive use. Ovarian dysfunction leading to both infertility and malignancy is an unlikely explanation for these trends for several reasons: 1) The trends were evident even among the highly parous; 2) risk among nulliparous women did not vary by marital status or gravidity; and 3) risk among ever-married women showed little relation to length of longest pregnancy attempt or history of clinically diagnosed infertility. Risk was increased among women who had used fertility drugs and among women with long total duration of premenopausal sexual activity without birth control; these associations were particularly strong among the nulligravid. No consistent trends in risk were seen with age at menarche, age at menopause, or duration of estrogen replacement therapy. A history of tubal ligation or of hystereclomy with ovarian conservation was associated with reduced ovarian cancer risk. These observations suggest that pregnancy, breast feeding, and oral contraceptive use induce biological changes that protect against ovarian malignancy, that, at most, a small fraction of the excess ovarian cancer risk among nulliparous women is due to infertility, and that any increased risk associated with infertility may be due to the use of fertility drugs. Am J Epidemiol 1992; 136: 1184–1203
estrogens; fertility agents, female; infertility; lactation; pregnancy
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C. Rodriguez, A. V. Patel, E. E. Calle, E. J. Jacob, and M. J. Thun Estrogen Replacement Therapy and Ovarian Cancer Mortality in a Large Prospective Study of US Women JAMA, March 21, 2001; 285(11): 1460 - 1465. [Abstract] [Full Text] [PDF]
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K. Ivarsson, K. Sundfeldt, M. Brannstrom, P. Hellberg, and P. O. Janson Diverse effects of FSH and LH on proliferation of human ovarian surface epithelial cells Hum. Reprod., January 1, 2001; 16(1): 18 - 23. [Abstract] [Full Text] [PDF]
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F. Parazzini, E. Ricci, C. Rosa, E. Negri, and C. La Vecchia Risk of endometrial cancer after use of fertility drugs Hum. Reprod., January 1, 2001; 16(1): 196 - 196. [Full Text] [PDF]
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D. Gallot, J.L. Pouly, L. Janny, G. Mage, M. Canis, A. Wattiez, and M.A. Bruhat Successful transfer of frozen-thawed embryos obtained immediately before radical surgery for stage IIIa serous borderline ovarian tumour: Case report Hum. Reprod., November 1, 2000; 15(11): 2347 - 2350. [Abstract] [Full Text] [PDF]
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W. Burke Oral Contraceptives and Breast Cancer: A Note of Caution for High-Risk Women JAMA, October 11, 2000; 284(14): 1837 - 1838. [Full Text] [PDF]
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T. E. C. Workshop Group Continuation rates for oral contraceptives and hormone replacement therapy Hum. Reprod., August 1, 2000; 15(8): 1865 - 1871. [Abstract] [Full Text] [PDF]
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R. B. Ness, J. Ann Grisso, J. Klapper, J. J. Schlesselman, S. Silberzweig, R. Vergona, M. Morgan, J. E. Wheeler, and and the SHARE Study Group Risk of Ovarian Cancer in Relation to Estrogen and Progestin Dose and Use Characteristics of Oral Contraceptives Am. J. Epidemiol., August 1, 2000; 152(3): 233 - 241. [Abstract] [Full Text] [PDF]
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C. Westhoff, J. A. Britton, M. D. Gammon, T. Wright, and J. L. Kelsey Oral Contraceptives and Benign Ovarian Tumors Am. J. Epidemiol., August 1, 2000; 152(3): 242 - 246. [Abstract] [Full Text] [PDF]
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T. Minegishi, T. Kameda, T. Hirakawa, K. Abe, M. Tano, and Y. Ibuki Expression of Gonadotropin and Activin Receptor Messenger Ribonucleic Acid in Human Ovarian Epithelial Neoplasms Clin. Cancer Res., July 1, 2000; 6(7): 2764 - 2770. [Abstract] [Full Text]
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K. Rosene-Montella, E. Keely, S. A. Laifer, and R. V. Lee Evaluation and Management of Infertility in Women: The Internists' Role Ann Intern Med, June 20, 2000; 132(12): 973 - 981. [Abstract] [Full Text] [PDF]
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B. Moloughney, J. Snider, and L. Villeneuve Ovarian cancer in Canada Can. Med. Assoc. J., March 1, 2000; 162(5): 690 - 690. [Full Text] [PDF]
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G. D. Adamson A 36-Year-Old Woman With Endometriosis, Pelvic Pain, and Infertility JAMA, December 22, 1999; 282(24): 2347 - 2354. [Full Text] [PDF]
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S. Marina, R. Exposito, F. Marina, J. Nadal, M. Masramon, and A. Verges Oocyte donor selection from 554 candidates Hum. Reprod., November 1, 1999; 14(11): 2770 - 2776. [Abstract] [Full Text] [PDF]
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K. J. Helzlsouer Bad News/Good News: Information About Breast Cancer Risk Following Prophylactic Oophorectomy J Natl Cancer Inst, September 1, 1999; 91(17): 1442 - 1443. [Full Text] [PDF]
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R. B. Ness and C. Cottreau Possible Role of Ovarian Epithelial Inflammation in Ovarian Cancer J Natl Cancer Inst, September 1, 1999; 91(17): 1459 - 1467. [Abstract] [Full Text] [PDF]
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F. P. Li and A. S. Whittemore Genetically Tailored Preventive Strategies: an Effective Plan for the Twenty-first Century? Cancer Epidemiol. Biomarkers Prev., August 1, 1999; 8(8): 649 - 658. [Abstract] [Full Text]
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E. Salazar-Martinez, E. C. Lazcano-Ponce, G. G. Lira-Lira, P. E.-D. los Rios, J. Salmeron-Castro, and M. Hernandez-Avila Reproductive Factors of Ovarian and Endometrial Cancer Risk in a High Fertility Population in Mexico Cancer Res., August 1, 1999; 59(15): 3658 - 3662. [Abstract] [Full Text] [PDF]
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K. A. Jaroudi, J. M.G. Hollanders, A. M. Elnour, G. L. Roca, A. M. Atared, and S. Coskun Embryo development and pregnancies from in-vitro matured and fertilized human oocytes Hum. Reprod., July 1, 1999; 14(7): 1749 - 1751. [Abstract] [Full Text] [PDF]
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A. Tokumura, M. Miyake, Y. Nishioka, S. Yamano, T. Aono, and K. Fukuzawa Production of Lysophosphatidic Acids by Lysophospholipase D in Human Follicular Fluids of In Vitro Fertilization Patients Biol Reprod, July 1, 1999; 61(1): 195 - 199. [Abstract] [Full Text]
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F. Cosman and R. Lindsay Selective Estrogen Receptor Modulators: Clinical Spectrum Endocr. Rev., June 1, 1999; 20(3): 418 - 434. [Abstract] [Full Text]
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S. C. Rubin Chemoprevention of Hereditary Ovarian Cancer N. Engl. J. Med., August 13, 1998; 339(7): 469 - 471. [Full Text]
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C. K. Welt, G. Lambert-Messerlian, W. Zheng, W. F. Crowley Jr., and A. L. Schneyer Presence of Activin, Inhibin, and Follistatin in Epithelial Ovarian Carcinoma J. Clin. Endocrinol. Metab., November 1, 1997; 82(11): 3720 - 3727. [Abstract] [Full Text] [PDF]
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K. J. Helzlsouer, A. J. Alberg, G. B. Gordon, C. Longcope, T. L. Bush, S. C. Hoffman, and G. W. Comstock Serum Gonadotropins and Steroid Hormones and the Development of Ovarian Cancer JAMA, December 27, 1995; 274(24): 1926 - 1930. [Abstract] [PDF]
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G. Del Priore, K. Robischon, W. R. Phipps, R. Kurman, E. E. Wallach, H. A. Zacur, S. Shapiro, M. A. Rossing, J. R. Daling, N. S. Weiss, et al. Risk of Ovarian Cancer after Treatment for Infertility N. Engl. J. Med., May 11, 1995; 332(19): 1300 - 1302. [Full Text]
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M. A. Rossing, J. R. Daling, N. S. Weiss, D. E. Moore, and S. G. Self Ovarian Tumors in a Cohort of Infertile Women N. Engl. J. Med., September 22, 1994; 331(12): 771 - 776. [Abstract] [Full Text]
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