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Hormonal and reproductive factors and the risk of ovarian cancer

  • Koushik, Anita1, 2
  • Grundy, Anne1, 2
  • Abrahamowicz, Michal3, 4
  • Arseneau, Jocelyne5, 6
  • Gilbert, Lucy6
  • Gotlieb, Walter H.7
  • Lacaille, Julie1
  • Mes-Masson, Anne-Marie1, 8
  • Parent, Marie-Élise1, 2, 9
  • Provencher, Diane M.1, 10
  • Richardson, Lesley1
  • Siemiatycki, Jack1, 2
  • 1 Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada , Montreal (Canada)
  • 2 Université de Montréal, Department of Social and Preventive Medicine, Montreal, QC, Canada , Montreal (Canada)
  • 3 McGill University, Department of Epidemiology, Biostatistics and Occupational Health, Montreal, QC, Canada , Montreal (Canada)
  • 4 McGill University Health Centre (MUHC), Division of Clinical Epidemiology, Montreal, QC, Canada , Montreal (Canada)
  • 5 McGill University Health Centre, Department of Pathology, Montreal, QC, Canada , Montreal (Canada)
  • 6 McGill University Health Centre, Gynecologic Oncology Unit, Montreal, QC, Canada , Montreal (Canada)
  • 7 Sir Mortimer B. Davis-Jewish General Hospital, Gynecologic Oncology and Colposcopy, Montreal, QC, Canada , Montreal (Canada)
  • 8 Université de Montréal, Department of Medicine, Montreal, QC, Canada , Montreal (Canada)
  • 9 University of Quebec, INRS-Institut Armand-Frappier, Laval, QC, Canada , Laval (Canada)
  • 10 Centre hospitalier de l’Université de Montréal, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Montreal, QC, Canada , Montreal (Canada)
Published Article
Cancer Causes & Control
Publication Date
Jan 19, 2017
DOI: 10.1007/s10552-016-0848-9
Springer Nature


PurposeHormone-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.MethodsA 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.ResultsParity 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.ConclusionsThese results suggest that associations with some hormone-related factors may differ between borderline and invasive Type I and II ovarian cancers.

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