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Hormonal and reproductive factors and the risk of ovarian cancer

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Abstract

Purpose

Hormone-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.

Methods

A 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.

Results

Parity 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.

Conclusions

These 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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Acknowledgments

This research was supported by the Canadian Cancer Society (Grant #700485) and the Cancer Research Society, the Fonds de recherche du Québec-Santé, and the Ministère de l’Économie de la Science et de l’Innovation du Québec GRePEC program (Grant #16264). Dr. Koushik was supported by the Cancer Research Society-Cancer Guzzo Université de Montréal Award, the Fonds de recherche du Québec-Santé Research Scholar Program, and the Canadian Institutes of Health Research New Investigator program. Dr. Abrahamowicz is a James McGill Professor at McGill University. Dr. Siemiatycki holds the Guzzo-Cancer Research Society Chair in Environment and Cancer. The CRCHUM and the MUHC Research Institute receive support from the Fonds de recherche du Québec-Santé. We are grateful to our interviewers Claire Walker, Françoise Pineault, and Martine Le Comte, and to Ana Gueorguieva for data management. We also thank our additional clinical collaborators Drs. Suzanne Fortin, Dominique Tremblay and Michel Welt.

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Authors and Affiliations

  1. Université de Montréal Hospital Research Centre (CRCHUM), 850 Saint-Denis Street, 2nd Floor, Montreal, QC, H2X 0A9, Canada

    Anita Koushik, Anne Grundy, Julie Lacaille, Anne-Marie Mes-Masson, Marie-Élise Parent, Diane M. Provencher, Lesley Richardson & Jack Siemiatycki

  2. Department of Social and Preventive Medicine, Université de Montréal, Montreal, QC, Canada

    Anita Koushik, Anne Grundy, Marie-Élise Parent & Jack Siemiatycki

  3. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada

    Michal Abrahamowicz

  4. Division of Clinical Epidemiology, McGill University Health Centre (MUHC), Montreal, QC, Canada

    Michal Abrahamowicz

  5. Department of Pathology, McGill University Health Centre, Montreal, QC, Canada

    Jocelyne Arseneau

  6. Gynecologic Oncology Unit, McGill University Health Centre, Montreal, QC, Canada

    Jocelyne Arseneau & Lucy Gilbert

  7. Gynecologic Oncology and Colposcopy, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, QC, Canada

    Walter H. Gotlieb

  8. Department of Medicine, Université de Montréal, Montreal, QC, Canada

    Anne-Marie Mes-Masson

  9. INRS-Institut Armand-Frappier, University of Quebec, Laval, QC, Canada

    Marie-Élise Parent

  10. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Centre hospitalier de l’Université de Montréal, Montreal, QC, Canada

    Diane M. Provencher

Authors
  1. Anita Koushik
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  2. Anne Grundy
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  3. Michal Abrahamowicz
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  4. Jocelyne Arseneau
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  7. Julie Lacaille
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  9. Marie-Élise Parent
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  11. Lesley Richardson
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  12. Jack Siemiatycki
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Corresponding author

Correspondence to Anita Koushik.

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Koushik, A., Grundy, A., Abrahamowicz, M. et al. Hormonal and reproductive factors and the risk of ovarian cancer. Cancer Causes Control 28, 393–403 (2017). https://doi.org/10.1007/s10552-016-0848-9

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  • DOI: https://doi.org/10.1007/s10552-016-0848-9

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