Cancer Causes & Control

, Volume 24, Issue 5, pp 989–1004

Cigarette smoking and risk of ovarian cancer: a pooled analysis of 21 case–control studies

  • Mette T. Faber
  • Susanne K. Kjær
  • Christian Dehlendorff
  • Jenny Chang-Claude
  • Klaus K. Andersen
  • Estrid Høgdall
  • Penelope M. Webb
  • Susan J. Jordan
  • The Australian Cancer Study (Ovarian Cancer)
  • Australian Ovarian Cancer Study Group
  • Mary Anne Rossing
  • Jennifer A. Doherty
  • Galina Lurie
  • Pamela J. Thompson
  • Michael E. Carney
  • Marc T. Goodman
  • Roberta B. Ness
  • Francesmary Modugno
  • Robert P. Edwards
  • Clareann H. Bunker
  • Ellen L. Goode
  • Brooke L. Fridley
  • Robert A. Vierkant
  • Melissa C. Larson
  • Joellen Schildkraut
  • Daniel W. Cramer
  • Kathryn L. Terry
  • Allison F. Vitonis
  • Elisa V. Bandera
  • Sara H. Olson
  • Melony King
  • Urmila Chandran
  • Lambertus A. Kiemeney
  • Leon F. A. G. Massuger
  • Anne M. van Altena
  • Sita H. Vermeulen
  • Louise Brinton
  • Nicolas Wentzensen
  • Jolanta Lissowska
  • Hannah P. Yang
  • Kirsten B. Moysich
  • Kunle Odunsi
  • Karin Kasza
  • Oluwatosin Odunsi-Akanji
  • Honglin Song
  • Paul Pharaoh
  • Mitul Shah
  • Alice S. Whittemore
  • Valerie McGuire
  • Weiva Sieh
  • Rebecca Sutphen
  • Usha Menon
  • Simon A. Gayther
  • Susan J. Ramus
  • Aleksandra Gentry-Maharaj
  • Celeste Leigh Pearce
  • Anna H. Wu
  • Malcolm C. Pike
  • Harvey A. Risch
  • Allan Jensen
  • On behalf of the Ovarian Cancer Association Consortium
Original paper

DOI: 10.1007/s10552-013-0174-4

Cite this article as:
Faber, M.T., Kjær, S.K., Dehlendorff, C. et al. Cancer Causes Control (2013) 24: 989. doi:10.1007/s10552-013-0174-4

Abstract

Purpose

The majority of previous studies have observed an increased risk of mucinous ovarian tumors associated with cigarette smoking, but the association with other histological types is unclear. In a large pooled analysis, we examined the risk of epithelial ovarian cancer associated with multiple measures of cigarette smoking with a focus on characterizing risks according to tumor behavior and histology.

Methods

We used data from 21 case–control studies of ovarian cancer (19,066 controls, 11,972 invasive and 2,752 borderline cases). Study-specific odds ratios (OR) and 95 % confidence intervals (CI) were obtained from logistic regression models and combined into a pooled odds ratio using a random effects model.

Results

Current cigarette smoking increased the risk of invasive mucinous (OR = 1.31; 95 % CI: 1.03–1.65) and borderline mucinous ovarian tumors (OR = 1.83; 95 % CI: 1.39–2.41), while former smoking increased the risk of borderline serous ovarian tumors (OR = 1.30; 95 % CI: 1.12–1.50). For these histological types, consistent dose–response associations were observed. No convincing associations between smoking and risk of invasive serous and endometrioid ovarian cancer were observed, while our results provided some evidence of a decreased risk of invasive clear cell ovarian cancer.

Conclusions

Our results revealed marked differences in the risk profiles of histological types of ovarian cancer with regard to cigarette smoking, although the magnitude of the observed associations was modest. Our findings, which may reflect different etiologies of the histological types, add to the fact that ovarian cancer is a heterogeneous disease.

Keywords

Case–control studiesHistological typeOvarian neoplasmsSmoking

Copyright information

© Springer Science+Business Media Dordrecht 2013

Authors and Affiliations

  • Mette T. Faber
    • 1
  • Susanne K. Kjær
    • 1
    • 2
  • Christian Dehlendorff
    • 3
  • Jenny Chang-Claude
    • 4
  • Klaus K. Andersen
    • 3
  • Estrid Høgdall
    • 1
    • 5
  • Penelope M. Webb
    • 6
  • Susan J. Jordan
    • 6
  • The Australian Cancer Study (Ovarian Cancer)
    • 6
  • Australian Ovarian Cancer Study Group
    • 6
    • 7
  • Mary Anne Rossing
    • 8
    • 9
  • Jennifer A. Doherty
    • 8
    • 10
  • Galina Lurie
    • 11
  • Pamela J. Thompson
    • 11
  • Michael E. Carney
    • 11
  • Marc T. Goodman
    • 11
  • Roberta B. Ness
    • 12
  • Francesmary Modugno
    • 13
  • Robert P. Edwards
    • 14
  • Clareann H. Bunker
    • 15
  • Ellen L. Goode
    • 16
  • Brooke L. Fridley
    • 17
  • Robert A. Vierkant
    • 17
  • Melissa C. Larson
    • 17
  • Joellen Schildkraut
    • 18
    • 19
  • Daniel W. Cramer
    • 20
  • Kathryn L. Terry
    • 21
  • Allison F. Vitonis
    • 20
  • Elisa V. Bandera
    • 21
  • Sara H. Olson
    • 22
  • Melony King
    • 23
  • Urmila Chandran
    • 21
  • Lambertus A. Kiemeney
    • 24
    • 25
    • 26
  • Leon F. A. G. Massuger
    • 27
  • Anne M. van Altena
    • 27
  • Sita H. Vermeulen
    • 24
  • Louise Brinton
    • 28
  • Nicolas Wentzensen
    • 28
  • Jolanta Lissowska
    • 29
  • Hannah P. Yang
    • 28
  • Kirsten B. Moysich
    • 30
  • Kunle Odunsi
    • 31
  • Karin Kasza
    • 30
  • Oluwatosin Odunsi-Akanji
    • 30
  • Honglin Song
    • 32
  • Paul Pharaoh
    • 32
  • Mitul Shah
    • 32
  • Alice S. Whittemore
    • 33
  • Valerie McGuire
    • 33
  • Weiva Sieh
    • 33
  • Rebecca Sutphen
    • 34
  • Usha Menon
    • 35
  • Simon A. Gayther
    • 36
  • Susan J. Ramus
    • 37
  • Aleksandra Gentry-Maharaj
    • 35
  • Celeste Leigh Pearce
    • 36
  • Anna H. Wu
    • 36
  • Malcolm C. Pike
    • 22
    • 36
  • Harvey A. Risch
    • 37
  • Allan Jensen
    • 1
  • On behalf of the Ovarian Cancer Association Consortium
  1. 1.Unit of Virus, Lifestyle and GenesDanish Cancer Society Research CenterCopenhagenDenmark
  2. 2.Gynecologic ClinicCopenhagen University HospitalCopenhagenDenmark
  3. 3.Unit of Statistics, Bioinformatics and RegistryDanish Cancer Society Research CenterCopenhagenDenmark
  4. 4.Division of Cancer EpidemiologyGerman Cancer Research CenterHeidelbergGermany
  5. 5.Molecular Unit, Department of PathologyHerlev University Hospital, University of CopenhagenCopenhagenDenmark
  6. 6.Population Health DepartmentQueensland Institute of Medical ResearchBrisbaneAustralia
  7. 7.Peter MacCallum Cancer CentreEast MelbourneAustralia
  8. 8.Program in Epidemiology, Division of Public Health SciencesFred Hutchinson Cancer Research CenterSeattleUSA
  9. 9.Department of EpidemiologyUniversity of WashingtonSeattleUSA
  10. 10.Department of Community and Family Medicine, Section of Biostatistics and EpidemiologyThe Geisel School of Medicine at DartmouthLebanonUSA
  11. 11.Epidemiology ProgramUniversity of Hawaii Cancer CenterHonoluluUSA
  12. 12.School of Public HealthUniversity of TexasHoustonUSA
  13. 13.Division of Gyn/Onc, Department of Ob/Gyn/RS, School of Medicine and Department of Epidemiology, Graduate School of Public Health, Ovarian Cancer Center of ExcellenceWomen’s Cancer Program, Magee-Women’s Research Institute, University of Pittsburgh Cancer Institute, University of PittsburghPittsburghUSA
  14. 14.Division of Gyn/Onc, Department of Ob/Gyn/RS, and Ovarian Cancer Center of ExcellenceUniversity of PittsburghPittsburghUSA
  15. 15.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  16. 16.Division of Epidemiology, Department of Health Science ResearchMayo Clinic College of MedicineRochesterUSA
  17. 17.Division of Biomedical Statistics and Informatics, Department of Health Science ResearchMayo ClinicRochesterUSA
  18. 18.Department of Community and Family MedicineDuke University Medical CenterDurhamUSA
  19. 19.Cancer Prevention, Detection & Control Research ProgramDuke Cancer InstituteDurhamUSA
  20. 20.Obstetrics and Gynecology Epidemiology CenterBrigham and Women’s HospitalBostonUSA
  21. 21.Robert Wood Johnson Medical SchoolThe Cancer Institute of New JerseyNew BrunswickUSA
  22. 22.Department of Epidemiology and BiostatisticsMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  23. 23.UMDNJ-School of Public HealthPiscatawayUSA
  24. 24.Department of Epidemiology, Biostatistics and HTARadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  25. 25.Department of UrologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  26. 26.Comprehensive Cancer CenterRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  27. 27.Department of GynecologyRadboud University Nijmegen Medical CentreNijmegenThe Netherlands
  28. 28.Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA
  29. 29.Department of Cancer Epidemiology and PreventionM. Sklodowska-Curie Memorial Cancer Center and Institute of OncologyWarsawPoland
  30. 30.Department of Cancer Prevention and ControlRoswell Park Cancer InstituteBuffaloUSA
  31. 31.Department of Gynecological OncologyRoswell Park Cancer InstituteBuffaloUSA
  32. 32.Strangeways Research Laboratory, Department of OncologyUniversity of CambridgeCambridgeUK
  33. 33.Department of Health Research and Policy, EpidemiologyStanford University School of MedicineStanfordUSA
  34. 34.Epidemiology Center, College of MedicineUniversity of South FloridaTampaUSA
  35. 35.Womens Cancer, EGA Institute for Women’s HealthUniversity College LondonLondonUK
  36. 36.Department of Preventive Medicine, Keck School of MedicineUniversity of Southern California Norris Comprehensive Cancer CenterLos AngelesUSA
  37. 37.Department of Epidemiology and Public HealthYale University School of Public Health and School of MedicineNew HavenUSA