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Lingeman CH. Environmental Factors in the Etiology of Carcinoma of the Human Ovary: A Review. Am J Ind Med 2017. [DOI: 10.1002/ajim.1983.4.1-2.365] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Gong TT, Wu QJ, Vogtmann E, Lin B, Wang YL. Age at menarche and risk of ovarian cancer: a meta-analysis of epidemiological studies. Int J Cancer 2012; 132:2894-900. [PMID: 23175139 DOI: 10.1002/ijc.27952] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 11/08/2012] [Indexed: 01/22/2023]
Abstract
Epidemiological studies have reported inconsistent associations between menarcheal age and ovarian cancer risk. To our knowledge, a meta-analysis for the association between menarcheal age and ovarian cancer has not been reported. Relevant published studies of menarcheal age and ovarian cancer were identified using MEDLINE, EMBASE and Web of Science through the end of April 2012. Two authors (T-T.G. and Q-J.W.) independently assessed eligibility and extracted data. We pooled the relative risks (RRs) from individual studies using a random-effects model and performed heterogeneity and publication bias analyses. A total of 27 observational studies consisting of 22 case-control and five cohort studies were included in our analysis. In a pooled analysis of all studies, a statistically significant inverse association was observed between menarcheal age (for the oldest compared to the youngest category) and ovarian cancer risk (RR = 0.85; 95% confidence interval [CI] = 0.75-0.97). The pooled RRs of ovarian cancer for the oldest versus the youngest categories of menarcheal age in prospective and case-control studies were 0.89 (95% CI = 0.76-1.03) and 0.84 (95% CI = 0.70-0.99), respectively. Inverse associations between menarcheal age and ovarian cancer risk were observed in most subgroups; however, the significant association was restricted to invasive and borderline serous ovarian cancer. In conclusion, findings from this meta-analysis support that menarcheal age was inversely associated with the risk of ovarian cancer. More large studies are warranted to stratify these results by different cancer grading and histotype of ovarian cancer.
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Affiliation(s)
- Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital, China Medical University, Shenyang, Liaoning, People's Republic of China
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Olsen CM, Nagle CM, Whiteman DC, Purdie DM, Green AC, Webb PM. Body size and risk of epithelial ovarian and related cancers: a population-based case-control study. Int J Cancer 2008; 123:450-456. [PMID: 18449887 DOI: 10.1002/ijc.23509] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Different subtypes of ovarian cancer appear to have different causes; however, the association between body mass index (BMI) and the different subtypes is unclear. We examined the associations between body-mass index (BMI) and weight gain and risk of the different histological subtypes of epithelial ovarian cancer in a case-control study in Australia. Cases aged 18-79 with a new diagnosis of invasive epithelial ovarian cancer (n = 1,269) or borderline tumor (n = 311) were identified through a network of clinics and cancer registries throughout Australia. Controls (n = 1,509) were selected from the Electoral Roll. Height and weight (1 year previously, at age 20 and maximum weight) and other risk factor information were ascertained via a self-administered questionnaire. Obesity was positively associated with clear cell tumors (Odds Ratio 2.3; 95% confidence interval 1.2-4.2) but not invasive endometrioid or mucinous tumors. Although there was no association with invasive serous tumors overall (0.9; 0.7-1.2), we did see an increased risk of serous peritoneal tumors (2.9; 1.7-4.9), but not of serous tumors of the ovary and fallopian tube. Of the borderline subtypes, obesity was positively associated with serous (1.8; 1.1-2.8) but not mucinous tumors (1.1; 0.7-1.7). Overweight was not associated with any subtype overall. There was no association with BMI at age 20, or weight gain for any of the histological subtypes. These results add to the current evidence that obesity increases a woman's risk of developing distinct histological subtypes of ovarian cancer.
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Affiliation(s)
- Catherine M Olsen
- Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia.,School of Population Health, University of Queensland, Brisbane, Australia
| | - Christina M Nagle
- Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
| | - David C Whiteman
- Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
| | - David M Purdie
- Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
| | - Adèle C Green
- Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
| | - Penelope M Webb
- Cancer and Population Studies Group, Queensland Institute of Medical Research, Brisbane, Australia
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Vo C, Carney ME. Ovarian cancer hormonal and environmental risk effect. Obstet Gynecol Clin North Am 2008; 34:687-700, viii. [PMID: 18061864 DOI: 10.1016/j.ogc.2007.09.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
To understand the influence of hormonal and environmental factors on the risk of ovarian cancer, it is important to remember the established risk factors and postulated mechanisms that lead to the development of ovarian cancer. Several risk factors have been identified as increasing the risk of epithelial ovarian cancer, including low pariety, infertility, early age of menarche, and late age of menopause. This article discusses the different hypotheses and focuses on hormonal and environmental risk factors, as well the chemoprevention of epithelial ovarian cancer.
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Affiliation(s)
- Christine Vo
- Department of Obstetrics, Gynecology and Women's Health, Cancer Research Center of Hawaii, University of Hawaii, 1236 Lauhala Street, Honolulu, HI 96813, USA
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Brinton LA, Sakoda LC, Frederiksen K, Sherman ME, Kjaer SK, Graubard BI, Olsen JH, Mellemkjaer L. Relationships of uterine and ovarian tumors to pre-existing chronic conditions. Gynecol Oncol 2007; 107:487-94. [PMID: 17825884 PMCID: PMC2199881 DOI: 10.1016/j.ygyno.2007.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 07/24/2007] [Accepted: 08/03/2007] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Several chronic diseases have been hypothesized to affect the risk of subsequent gynecologic malignancies, possibly through shared hormonal mechanisms. METHODS Using record linkage techniques, we assessed the relationships between hospital and outpatient admissions for gallbladder disease, diabetes, hypertension, thyroid diseases and obesity and the subsequent development of uterine and ovarian cancers in Denmark between 1978 and 1998. Based on a subsample of more than 99,000 women, including 1398 uterine and 2491 ovarian cancers, we derived relative risks (RRs) and 95% confidence intervals (CIs) associated with overall and histology-specific cancer risks after adjustment for age, calendar time and reproductive characteristics. RESULTS Uterine cancers were related to previous diagnoses of thyroid diseases (RR=1.52, 95% CI 1.17-1.98) and obesity (2.05, 1.40-3.00). Associations with diabetes were confounded by obesity, but there were some elevations in risk for subjects diagnosed with obesity prior to age 45 (RRs 1.66-1.79). Although the "usual types" of endometrial cancer largely accounted for the observed associations, there was some evidence that uterine sarcomas (n=137) were related to prior diagnoses of thyroid diseases (2.78, 1.41-5.50). In contrast, ovarian cancers were not strongly related to most documented chronic diseases. Serous carcinomas were associated with gallbladder diseases of short durations, but detection bias or misdiagnosis probably accounts for this association. An association of obesity and endometrioid ovarian cancer was not identified. CONCLUSIONS Uterine cancers, including sarcomas, appear to be influenced by selected chronic diseases. Further attention should focus on possible biologic mechanisms underlying observed associations with thyroid diseases and obesity.
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Affiliation(s)
- Louise A Brinton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
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Olsen CM, Green AC, Whiteman DC, Sadeghi S, Kolahdooz F, Webb PM. Obesity and the risk of epithelial ovarian cancer: a systematic review and meta-analysis. Eur J Cancer 2007; 43:690-709. [PMID: 17223544 DOI: 10.1016/j.ejca.2006.11.010] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2006] [Revised: 11/02/2006] [Accepted: 11/27/2006] [Indexed: 12/20/2022]
Abstract
Obesity is a risk factor for several hormone-related cancers but evidence for an effect on risk of epithelial ovarian cancer remains inconclusive. Many studies evaluating this association have had insufficient statistical power to detect modest effects, particularly for histological subtypes of ovarian cancer. We have therefore assembled the published evidence on obesity and ovarian cancer in a systematic literature review and meta-analysis. We identified eligible studies using Medline and manual review of retrieved references, and included all population-based studies that assessed the association between overweight, body mass index (BMI25-29.9) and obesity (BMI30) and histologically confirmed ovarian cancer. Meta-analysis was restricted to those studies that expressed effect as an odds ratio (OR), risk ratio, or standardised incidence ratio and 95% confidence interval (CI). We identified 28 eligible studies, of which 16 on adult obesity and 9 on obesity in early adulthood were suitable for meta-analysis. Overall, 24 of 28 studies reported a positive association between obesity and ovarian cancer, and in 10 this reached statistical significance. The pooled effect estimate for adult obesity was 1.3 (95%CI1.1-1.5) with a smaller increased risk for overweight (OR1.2;95%CI1.0-1.3). The pooled OR was stronger among case-control studies (OR=1.5) than cohort studies (OR=1.1). Overweight/obesity in early adulthood was also associated with an increased risk of ovarian cancer. There was no evidence that the association varied for the different histological subtypes of ovarian cancer. Ovarian cancer should be added to the list of cancers likely to be related to obesity.
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Affiliation(s)
- Catherine M Olsen
- Cancer and Population Studies Group, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Herston, Brisbane, Qld 4029, Australia.
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Schulz M, Lahmann PH, Riboli E, Boeing H. Dietary Determinants of Epithelial Ovarian Cancer: A Review of the Epidemiologic Literature. Nutr Cancer 2004; 50:120-40. [PMID: 15623459 DOI: 10.1207/s15327914nc5002_2] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Ovarian cancer is commonly a fatal disease and, despite advances in screening and treatment, the lack of understanding of the underlying etiology has limited prevention strategies. This article reviews the epidemiologic literature on the relationship between consumption of major food groups and the risk of epithelial ovarian cancer (EOC). We identified 7 cohort studies and 27 case-control studies of consumption of major food groups (fruits and vegetables, meats, eggs, fish, dairy products, grains, fats and oils) and EOC risk. Vegetable but not fruit consumption was found to possibly exhibit beneficial effects on the risk of EOC, whereas high meat consumption may be associated with an increased risk. A protective effect on risk of EOC for whole-grain food consumption as well as for consumption of low-fat milk is suggested by the results of the studies. However, evidence for associations of foods such as fish, grains, milk products, and fats and oils with EOC risk is limited and inconsistent, and further examination of these dietary determinants of EOC are warranted. In conclusion, a typical Western diet, which is high in meats and low in vegetables, may be positively associated with ovarian cancer incidence. However, the association between specific dietary factors and EOC risk remains unclear and merits further examination. In particular, future studies need to address the effect of milk products according to fat content and possible biological mechanisms to explain observed effects.
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Affiliation(s)
- Mandy Schulz
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany.
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Riman T, Persson I, Nilsson S. Hormonal aspects of epithelial ovarian cancer: review of epidemiological evidence. Clin Endocrinol (Oxf) 1998; 49:695-707. [PMID: 10209555 DOI: 10.1046/j.1365-2265.1998.00577.x] [Citation(s) in RCA: 143] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Epithelial ovarian cancer is fairly common with high rates in Scandinavia, intermediate rates in western Europe and North America and low rates in the developing countries and in Japan. The 5-year survival rate is less than 40%. Increasing parity consistently gives a strong protection against epithelial ovarian cancer. A lesser degree of protection is probably derived from incomplete pregnancies and lactation. Ages at menarche and menopause are most probably weak predictors of epithelial ovarian cancer risk. Ever users of oral contraceptives (OC) have 30% lower risk compared to never users. The protection increases with duration of OC use, being about 50% after 5 years. The reduced risk among past OC users persists for at least 10 years after cessation of use. Results concerning hormone replacement therapy (HRT) and epithelial ovarian cancer risk are conflicting, but most data point to a weak or no association, but as an increasing number of women use HRT it still seems important to resolve any potential effect. Infertility adds to epithelial ovarian cancer risk in nulliparous women, while temporary fertility problems in parous women do not appear to increase risk. A possible independent risk effect of fertility drug use has not been easy to assess and remains unresolved. It has been particularly difficult to separate the effects of fertility drugs from those of infertility. Tubal ligation and hysterectomy convey protection against epithelial ovarian cancer, possibly through a suppressed ovarian hormone production. The causes of epithelial ovarian cancer are poorly understood, but reproductive hormones are thought to be involved in the aetiology. For a long time the 'incessant' and 'gonadotrophin' hypotheses have been promoted in relation to carcinogenesis. Both hypotheses find support in ovarian cancer epidemiology, and recent progress in molecular biology adds to the understanding of possible aetiological mechanisms. Another hypothesis focuses on the retrograde transport of contaminants or carcinogens through the Fallopian tubes. It is important to establish if the same risk factors apply to the various histological types of ovarian cancer, as particularly the mucinous ovarian tumours seem to present with different risk factors. Another question to resolve is if sporadic vs. inherited cases carry distinct risk profiles. As the hypotheses above do not explain all of the results derived from ovarian cancer epidemiology, there is a need to test additional hypotheses to possibly define preventive programmes and to come closer to the cause of ovarian cancer.
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Affiliation(s)
- T Riman
- Department of Medical Epidemiology, Karolinska Institute, Stockholm, Sweden
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Mori M, Nishida T, Sugiyama T, Komai K, Yakushiji M, Fukuda K, Tanaka T, Yokoyama M, Sugimori H. Anthropometric and other risk factors for ovarian cancer in a case-control study. Jpn J Cancer Res 1998; 89:246-53. [PMID: 9600117 PMCID: PMC5921796 DOI: 10.1111/j.1349-7006.1998.tb00555.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Because it has been suggested that an environmental factor may play a role in the etiology of ovarian cancer, a case-control study was conducted to assess some environmental and other risk factors for ovarian cancer from 1994 to 1996 in northern Kyushu, Japan. We analyzed the data of 89 cases with epithelial ovarian cancer and 323 controls without any cancer or ovarian disorder. After controlling for the effect of potential confounders, the odds ratios of ovarian cancer across increasing quartiles of the heaviest body weight were 1.00, 1.15, 1.71, 2.29 (P = 0.008, test for trend). Significantly increased risks were noted for a history of diabetes mellitus (P < 0.05), and for a family history of ovarian cancer (P < 0.05). Significantly decreased trends for risk were obtained for the number of pregnancies (P < 0.01) and the number of live births (P < 0.001). This study provides additional support for an association between obesity and the risk of ovarian cancer. This relationship may at least partly explain the recent increase in the incidence of ovarian cancer in Japan, although possible contributions of other factors can not be ruled out.
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Affiliation(s)
- M Mori
- Department of Community Health Science, Saga Medical School
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Parazzini F, Moroni S, La Vecchia C, Negri E, dal Pino D, Bolis G. Ovarian cancer risk and history of selected medical conditions linked with female hormones. Eur J Cancer 1997; 33:1634-7. [PMID: 9389926 DOI: 10.1016/s0959-8049(97)00011-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To investigate the role of selected medical conditions on the risk of ovarian cancer, we analysed data from a case-control study. Cases were 971 women below the age of 75 years with histologically confirmed epithelial ovarian cancer, admitted to a network of hospitals including the major teaching and general hospitals in the greater Milan area. Controls were 2758 women admitted to the same network of hospitals for acute, non-gynaecological, non-hormone related, non-neoplastic conditions. Obesity/severe overweight were inversely associated with the risk of ovarian cancer (multivariate relative risk, RR, 0.66, 95% confidence interval, CI, 0.52-0.85). Hyperlipidaemia was also inversely related to ovarian cancer risk, (RR 0.64, 95% CI 0.45-0.89). No relationship emerged between ovarian cancer risk and diabetes (RR 0.80, 95% CI 0.54-1.19), hypertension (RR 0.85, 95% CI 0.68-1.06), thyroid diseases (RR 0.89, 95% CI 0.63-1.13) and cholelithiasis (RR 0.86, 95% CI 0.66-1.12). A decreased frequency of ovarian cancer was seen in women with a history of uterine leiomyomas (RR 0.66, 95% CI 0.47-0.92) and benign ovarian cysts (RR 0.69, 95% CI 0.41-1.13).
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Affiliation(s)
- F Parazzini
- Istituto di Ricerche Farmacologiche, Mario Negri, Milan, Italy
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Albrektsen G, Heuch I, Kvåle G. Reproductive factors and incidence of epithelial ovarian cancer: a Norwegian prospective study. Cancer Causes Control 1996; 7:421-7. [PMID: 8813430 DOI: 10.1007/bf00052668] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
To examine relations between the risk of epithelial ovarian cancer and time-related effects of pregnancies, we analyzed data from a prospective study of 1,145,076 women in Norway aged 20 to 56 years. The mean follow-up time per woman was 16.4 years and a total of 1,694 women were diagnosed with epithelial ovarian cancer. Incidence rate ratios (IRR) were estimated by Poisson regression analysis of person-years at risk. The risk of epithelial ovarian cancer decreased with an increasing number of full-term pregnancies (IRR = 0.56, 95 percent confidence interval = 0.48-0.67 for three pregnancies cf one). However, no further reduction in risk was seen after the third pregnancy. The association with parity became weaker with increasing age at last birth. Further, the reduction in risk among parous women compared with nulliparous women was more pronounced shortly after birth. Both higher age at last birth and shorter time since last birth were associated with a reduction in risk, although these relations were seen mainly for the first and second births. Increasing age at first birth was associated with a decrease in risk among uniparous women but not among multiparous women. Our results indicate that the relations between the incidence of epithelial ovarian cancer and reproductive factors are more complex than previously believed.
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Affiliation(s)
- G Albrektsen
- Section for Medical Informatics and Statistics, University of Bergen, Norway
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Tortolero-Luna G, Mitchell MF. The epidemiology of ovarian cancer. JOURNAL OF CELLULAR BIOCHEMISTRY. SUPPLEMENT 1995; 23:200-7. [PMID: 8747397 DOI: 10.1002/jcb.240590927] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Ovarian cancer is the second most common cancer of the female reproductive system and the leading cause of death from gynecologic malignancies. In 1995, 26,600 women will be diagnosed with ovarian cancer in the U.S., and 14,500 women will die from the disease. Between 1986-1900, the overall age-adjusted incidence was 14.3/100,000 women; mortality was 7.8/100,000 women. Ovarian cancer, rare before age 40, increases steeply thereafter and peaks at ages 65-75. Incidence and mortality rates are higher among white women than among African-American women. Over the last three decades, ovarian cancer incidence has remained stable in high-risk countries, while an increasing trend has been reported in low-risk countries. Despite recent advancements in treatment, the overall five-year survival rates continues to be low (39%). Over 70% of ovarian tumors are diagnosed when regional or distant involvement has already occurred, causing survival rates to remain stable. The etiology of ovarian cancer is poorly understood. Most studies have focused on the epidemiology of invasive epithelial ovarian tumors, while few have explored the epidemiology of epithelial tumors of low malignant potential and nonepithelial tumors. Factors associated with an increased risk for invasive epithelial ovarian cancer include age, race, nulliparity, family history of ovarian cancer, and history of endometrial or breast cancer. Factors associated with a reduced risk are history of one or more full-term pregnancies, use of oral contraceptives, history of breast feeding, tubal ligation, and hysterectomy. Other factors such as infertility drugs, hormone replacement therapy, age at menarche, age at menopause, dietary factors, lactose intolerance, talc use, coffee and alcohol consumption have been suggested, but their role is still inconclusive.
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Affiliation(s)
- G Tortolero-Luna
- Department of Gynecologic Oncology, University of Texas M.D. Anderson Cancer Center, Houston 77030, USA
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Törnberg SA, Carstensen JM. Relationship between Quetelet's index and cancer of breast and female genital tract in 47,000 women followed for 25 years. Br J Cancer 1994; 69:358-61. [PMID: 8297735 PMCID: PMC1968670 DOI: 10.1038/bjc.1994.65] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The relationship between Quetelet's index and subsequent risk for cancer of endocrine target organs was studied in a cohort of 47,003 women, examined for height and weight in the years 1963-65, and followed up in the Swedish Cancer Register until 1987. High Quetelet's index was associated with a decreased risk for breast cancer among women less than 55 years of age at risk, while a high Quetelet's index predicted an increased risk among older women. Among women > or = 55 years of age, the excess relative risk for breast cancer associated with high Quetelet's index declined significantly during the follow-up period. Cancer of the ovaries and the uterine cervix were not significantly related to Quetelet's index in any age group. In women > or = 55 years of age, the relative risk for cancer of the uterine corpus associated to Quetelet's index was higher than that for breast cancer, and this association persisted during the entire follow-up period of more than 20 years. In spite of the fact that endometrial cancer is less common than breast cancer, because of the stronger relation between overweight and endometrial cancer, more endometrial cancer would be attributable to obesity than breast cancer.
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Affiliation(s)
- S A Törnberg
- Department of General Oncology, Radiumhemmet, Karolinska Hospital, Stockholm, Sweden
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Abstract
In a hospital-based case-control study, consumption of lactose-containing (dairy) foods and foods containing beta-carotene by 71 women with epithelial cancer of the ovary and 141 matched controls was investigated. No significant differences were found between cases and controls in the frequency of consumption of dairy foods or in the amount of lactose consumed. Consumption of carrots was found to decrease risk. Logistic regression analyses indicated a protective effect of high beta-carotene intake (odds ratio = 0.3, 95% confidence interval = 0.1-0.8), after adjusting for body mass, smoking, and lactose consumption.
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Affiliation(s)
- A Engle
- Division of Nutritional Carcinogenesis, American Health Foundation, New York, NY 10017
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Schiffman MH, Hartge P, Hoover RN, McGowan L, Lesher L, Norris HJ. Epithelial ovarian cancer. Gynecol Oncol 1989; 33:129-32. [PMID: 2703163 DOI: 10.1016/0090-8258(89)90619-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- M H Schiffman
- Environmental Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20892
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Kvåle G, Heuch I, Nilssen S, Beral V. Reproductive factors and risk of ovarian cancer: a prospective study. Int J Cancer 1988; 42:246-51. [PMID: 3403067 DOI: 10.1002/ijc.2910420217] [Citation(s) in RCA: 94] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Associations between reproductive factors and risk of ovarian cancer were examined in a prospective study of 60,565 women in Norway. A total of 445 women were diagnosed as having ovarian cancer during follow-up, from 1961 through 1980. The highest risk was observed among nulliparous women, and the risk decreased significantly with increasing parity. The estimated odds ratio for women with 5 or more births compared with one birth was 0.46, after adjustment for age, urban/rural place of residence and occupational class. Neither age at first or last birth, nor age at menarche or menopause, nor marital status, showed significant associations with ovarian cancer risk after adjustment for parity. The apparent protective effect of high parity was observed for epithelial as well as non-epithelial cancers, and for the separate histological types of epithelial cancer except mucinous cystadenocarcinomas.
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Affiliation(s)
- G Kvåle
- Department of Hygiene and Social Medicine, University of Bergen, Norway
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Schulz BO, Baker E, Krebs D, Sellin D. The prognostic value of age for patients with common epithelial ovarian cancer. J Cancer Res Clin Oncol 1985; 109:152-5. [PMID: 3980564 DOI: 10.1007/bf00391890] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
For 230 patients with common epithelial ovarian cancer, the prognostic impact of age was examined. Statistical analysis was done using proportional hazard models, 3- and 5-year survival rates and median survival of stratified groups, and the Kaplan-Meier mean. Taking the age-adjusted mortality into account, the prognosis of the older patients was significantly worse. This effect depended primarily on early mortality (survival time less than 2 months). A comparative analysis was made of the prognostic factors age, grade, and stage, taking into account the correlation between factors. This analysis showed that, for our series, age was of lesser prognostic significance than grading, and both of these were of much less prognostic importance than staging.
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Hughesdon PE. Benign endometrioid tumours of the ovary and the Müllerian concept of ovarian epithelial tumours. Histopathology 1984; 8:977-90. [PMID: 6526392 DOI: 10.1111/j.1365-2559.1984.tb02415.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The difficulties of a consistent Müllerian interpretation of the epithelial ovarian tumours include their inconstant hormonal responsiveness, the doubtful nature of the clear cell tumour and the apparent rarity of benign endometrioid forms. The reported frequency figures for the different types of endometrioid tumour suggest that their nature is made evident by proliferation. The appearance of indolent forms is explored by a study of inactive neoplastic areas associated with endometrioid carcinomas, or with proliferating endometrioid tumours or arising in endometriosis. These jointly suggest that most such tumours are identical with inactive 'serous' adenofibromas of glandular pattern and have senile endometrium as their prototype. Increasing proliferation develops more overt endometrioid forms which, if luxuriant, may be associated with corpus carcinoma. The endometrium of pregnancy is probably the prototype of the clear cell tumour, with a corresponding range of cell types. There is tenuous evidence that tumours may respond to steroid hormones if they arise in endometriosis and a difficulty of deducing such an origin is noted. The term 'serous' may be generic and comprise several different tissue types.
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Tzonou A, Day NE, Trichopoulos D, Walker A, Saliaraki M, Papapostolou M, Polychronopoulou A. The epidemiology of ovarian cancer in Greece: A case-control study. ACTA ACUST UNITED AC 1984; 20:1045-52. [PMID: 6540687 DOI: 10.1016/0277-5379(84)90107-x] [Citation(s) in RCA: 96] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
One hundred and fifty women with common malignant epithelial tumors of the ovary (cases) and 250 comparison women hospitalized for various orthopedic conditions were interviewed regarding demographic, reproductive, socio-economic and biomedical characteristics, including their use of coffee, tobacco, alcohol, drugs and exogenous estrogens. The data were analyzed with standard X2 procedures and by modelling relative risk (r) through multiple logistic regression. The main results are as follows: women with ovarian cancer had fewer liveborn children (one-tailed, P congruent to 0.13, for women with 4+ children, r = 0.6) and later menarche (P congruent to 0.02, for women with age at menarche 15+, r = 1.9) and menopause (P congruent to 0.07, for women with age at menopause 50+, r = 1.5); they were slightly taller and heavier (P congruent to 0.15 and 0.30 respectively); they belonged to smaller sibships (P congruent to 0.05); they reported more frequently than controls familial occurrence of ovarian, endometrial and breast cancer (P less than 0.05 in each instance); they were regular consumers of alcoholic beverages more frequently than controls, and the excess was both statistically significant (P congruent to 0.02) and dose-related; they were regular users of coffee slightly more frequently than controls (r = 1.2) but the excess was small and it was neither statistically significant nor dose-related (P congruent to 0.27); and they reported less frequently than controls the use of oral contraceptives (relative risk for users, 0.4; 95% confidence interval, 0.1-1.1).
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Abstract
A case-control study of 80 women with ovarian epithelial carcinoma and 160 individually age-matched controls were conducted to assess various factors associated with the incidence of ovarian cancer in Hokkaido, Japan. Among the characteristics studied, the following factors were significantly greater in the cases than in the controls: (1) blood group A; (2) never married or married late in life; (3) more frequent surgery for retroflexion of the uterus; (4) less use of contraceptive appliances; and (5) less daily use of cosmetics. It was inferred from these observations that ovarian cancer patients had a genetic predisposition and dysfunctional ovaries. Gonadal dysfunction among ovarian cancer patients presumably explained not only altered personality and behavior patterns, but also facilitated the pituitary gonadotropin activity which has been suggested as increasing the incidence of the disease experimentally.
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Anteby SO, Mor Yosef S, Schenker JG. Ovarian cancer. Geographical, host and environmental factors. An overview. ARCHIVES OF GYNECOLOGY 1983; 234:137-48. [PMID: 6364995 DOI: 10.1007/bf00207686] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The incidence of ovarian cancer is reviewed among different races and ethnic groups. We present the effect of socio-economic class, age, endocrinological factors, menstrual cycle, reproductive history, familial, and genetic factors, viral infections, chemical carcinogens, and previous exposure to radiation on the incidence of ovarian cancer. There is evidence that environmental factor affects the distribution of various types of ovarian cancer. Migration may also change the susceptibility to this disease and the mean age was varied between countries being lowest where incidence was highest. The disease appeared to have a familial incidence. The protective effect of oral contraceptive steroids and the role of asbestos as a chemical carcinogen are discussed.
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Lingeman CH. Environmental factors in the etiology of carcinoma of the human ovary: A review. Am J Ind Med 1983. [DOI: 10.1002/ajim.4700040126] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Heinonen PK, Tuimala R, Pyykkö K, Pystynen P. Peripheral venous concentrations of oestrogens in postmenopausal women with ovarian cancer. BRITISH JOURNAL OF OBSTETRICS AND GYNAECOLOGY 1982; 89:84-6. [PMID: 7059550 DOI: 10.1111/j.1471-0528.1982.tb04643.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Serum concentrations of oestrone, oestradiol and oestriol were measured in 23 postmenopausal women, 12 with ovarian cancer and 11 with genital prolapse. Oestrone (387.6 pmol/l) and oestradiol (72.7 pmol/l) levels were higher in the cancer group than those in the control group (159.8 and 27.5 pmol/l respectively), while oestriol levels did not differ (434.5-270.8 pmol/l). The results indicate abnormal ovarian function in postmenopausal patients with ovarian cancer.
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