1
|
Yang J, Sasamoto N, Babic A, Vitonis AF, Townsend MK, Titus L, Cramer DW, Tworoger SS, Terry KL. Intrauterine device use and risk of ovarian cancer: Results from the New England Case-Control study and Nurses' Health Studies. Int J Cancer 2021; 149:75-83. [PMID: 33634849 DOI: 10.1002/ijc.33531] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 02/03/2021] [Accepted: 02/11/2021] [Indexed: 01/08/2023]
Abstract
Results of studies assessing intrauterine device (IUD) use and ovarian cancer risk are inconsistent. We examined the association between IUD use, including duration, type and timing of use, and ovarian cancer risk using three population-based studies. Data from the New England Case-Control Study (NEC) and two prospective cohort studies, the Nurses' Health Studies (NHS/NHSII), were included in the analysis. Information on IUD use was collected by in-person interview in NEC and by biennial questionnaire in NHS/NHSII. We used unconditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (CI) in NEC and Cox regression to calculate hazard ratios (HR) and 95% CI in NHS/NHSII. We used meta-analysis to combine the NEC and the pooled NHS/NHSII results. Overall, IUD use was not associated with epithelial ovarian cancer risk (OR = 0.96, 95% CI: 0.81-1.14 in NEC; HR = 0.89, 95% CI: 0.69-1.15 in NHS/NHSII; combined RR = 0.94, 95% CI: 0.81-1.08). Among IUD users, older age at first use was associated with increased ovarian cancer risk (P-trend = .03). We did not observe significant associations by IUD type or duration of use. In conclusion, IUD use was not associated with ovarian cancer risk in our study.
Collapse
Affiliation(s)
- Jiaxi Yang
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Naoko Sasamoto
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ana Babic
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Allison F Vitonis
- Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Mary K Townsend
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Linda Titus
- Public Health, Muskie School of Public Service, University of Southern Maine, Portland, Maine, USA
| | - Daniel W Cramer
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shelley S Tworoger
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Kathryn L Terry
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA.,Department of Obstetrics and Gynecology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
4
|
Doherty JA, Jensen A, Kelemen LE, Pearce CL, Poole E, Schildkraut JM, Terry KL, Tworoger SS, Webb PM, Wentzensen N. Current Gaps in Ovarian Cancer Epidemiology: The Need for New Population-Based Research. J Natl Cancer Inst 2017; 109:3847624. [PMID: 29117355 DOI: 10.1093/jnci/djx144] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022] Open
Abstract
With recent ovarian cancer screening studies showing no clinically significant mortality benefit, preventing this disease, identifying high-risk populations, and extending survival remain priorities. However, several challenges are impeding progress in ovarian cancer research. With most studies capturing exposure information from 10 or more years ago, evaluation of how changing patterns of exposures, such as new oral contraceptive formulations and increased intrauterine device use, might influence ovarian cancer risk and survival is difficult. Risk factors for ovarian cancer should be evaluated in the context of tumor histotypes, which have unique molecular features and cells of origin; this is a task that requires large collaborative studies to achieve meaningful sample sizes. Importantly, identification of novel modifiable risk factors, in addition to those currently known to reduce risk (eg, childbearing, tubal ligation, oral contraceptive use), is needed; this is not feasibly implemented at a population level. In this Commentary, we describe important gaps in knowledge and propose new approaches to advance epidemiologic research to improve ovarian cancer prevention and survival, including updated classification of tumors, collection of data on changing and novel exposures, longer follow-up on existing studies, evaluation of diverse populations, development of better risk prediction models, and collaborating prospectively with consortia to develop protocols for new studies that will allow seamless integration for future pooled analyses.
Collapse
Affiliation(s)
| | - Jennifer A Doherty
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Allan Jensen
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Linda E Kelemen
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Celeste L Pearce
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Elizabeth Poole
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Joellen M Schildkraut
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Kathryn L Terry
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Shelley S Tworoger
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Penelope M Webb
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| | - Nicolas Wentzensen
- Affiliations of authors: Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, UT (JAD); Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark (AJ); Department of Public Health Sciences and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC (LEK); Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI (CLP); Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA (CLP); Channing Division of Network Medicine (EP, SST) and Obstetrics and Gynecology Epidemiology Center (KLT), Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (EP, SST, KLT); Department of Public Health Sciences, University of Virginia, Charlottesville, CA (JMS); Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Australia (PMW); Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD (NW)
| |
Collapse
|