American Journal of Epidemiology Advance Access published online on February 25, 2008
American Journal of Epidemiology, doi:10.1093/aje/kwn006
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Original Contribution |
Hormonal Risk Factors for Ovarian Cancer in Premenopausal and Postmenopausal Women
1 Department of Community and Family Medicine, Cancer Prevention, Detection and Control Research Program, Duke University Medical Center, Durham, NC
2 Department of Epidemiology, University of North Carolina-Chapel Hill, Chapel Hill, NC
3 Department of Statistical Science, Duke University, Durham, NC
4 Department of Pathology, Duke University Medical Center, Durham, NC
5 Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC
6 Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, Duke University Medical Center, Durham, NC
Correspondence to Dr. Patricia G. Moorman, Cancer Prevention, Detection and Control Research Program, Box 2949, Duke University Medical Center, 2424 Erwin Road, Suite 602, Durham, NC 27705 (e-mail: patricia.moorman{at}duke.edu).
Received for publication September 27, 2007. Accepted for publication January 4, 2008.
Ovarian cancer is most frequently diagnosed in postmenopausal women; however, the strongest risk predictors, pregnancy and oral contraceptive use, occur in most women in their twenties and thirties. Relatively few studies have examined how reproductive risk factors vary between pre- and postmenopausal ovarian cancer. The authors used data from a population-based, case-control study of ovarian cancer (896 cases, 967 controls) conducted in North Carolina from 1999 to 2006. Odds ratios and 95% confidence intervals were calculated by using unconditional logistic regression. Inverse associations with ovarian cancer were observed with duration of oral contraceptive use, later age at last use, and more recent use among premenopausal women; no significant associations were found for postmenopausal women. Analyses limited to oral contraceptive users showed that duration was a more significant predictor of risk than was timing of use. Parity was inversely associated with premenopausal but not postmenopausal ovarian cancer. Later age at pregnancy was associated with reduced risk for both pre- and postmenopausal women. Analyses among parous women showed that pregnancy timing was a stronger risk predictor than number of pregnancies. Findings suggest that associations between ovarian cancer and reproductive characteristics vary by menopausal status. Additional research is needed to further elucidate risk factors for postmenopausal disease.
case-control studies; contraceptives, oral; menopause; ovarian neoplasms; pregnancy
Abbreviations: OC, oral contraceptive
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