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Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis

Fu, Zhuxuan; Brooks, Maria Mori; Irvin, Sarah; Jordan, Susan; Aben, Katja KH; Anton-Culver, Hoda; Bandera, Elisa V; ... Ovarian Cancer Association Consortium; + view all (2023) Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis. Journal of the National Cancer Institute , 115 (5) pp. 539-551. 10.1093/jnci/djad011. Green open access

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Abstract

BACKGROUND: The role of ovulation in epithelial ovarian cancer (EOC) is supported by the consistent protective effects of parity and oral contraceptive (OC) use. Whether these factors protect through anovulation alone remains unclear. We explored the association between lifetime ovulatory years (LOY) and EOC. METHODS: LOY was calculated using 12 algorithms. Odds ratios (ORs) and 95% confidence intervals (CIs) estimated the association between LOY or LOY components and EOC among 26,204 controls and 21,267 cases from 25 studies. To assess whether LOY components act through ovulation suppression alone, we compared beta coefficients obtained from regression models to expected estimates assuming one year of ovulation suppression has the same effect regardless of source. RESULTS: LOY was associated with increased EOC risk (ORs per year increase: 1.014 (95%CI 1.009-1.020) to 1.044 (95%CI 1.041-1.048)). Individual LOY components, except age at menarche, also associated with EOC. The estimated model coefficient for OC use and pregnancies were 4.45 times and 12-15 fold greater than expected, respectively. LOY was associated with high-grade serous (HGSOC), low-grade serous (LGSOC), endometrioid, and clear cell histotypes (ORs per year increase: 1.054, 1.040, 1.065, and 1.098, respectively), but not mucinous tumors. Estimated coefficients of LOY components were close to expected estimates for HGSOC but larger than expected for LGSOC, endometrioid, and clear cell histotypes. CONCLUSIONS: LOY is positively associated with non-mucinous EOC. Differences between estimated and expected model coefficients for LOY components suggest factors beyond ovulation underlie the associations between LOY components and EOC in general and for non-HGSOC.

Type: Article
Title: Lifetime ovulatory years and risk of epithelial ovarian cancer: a multinational pooled analysis
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/jnci/djad011
Publisher version: https://doi.org/10.1093/jnci/djad011
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: OCAC, case-control study, epithelial ovarian cancer, incessant ovulation, lifetime ovulation years, pooled analysis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10164235
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