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Cigarette smoking and the association with serous ovarian cancer in African American women: African American Cancer Epidemiology Study (AACES)

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Abstract

Background

Smoking is a risk factor for mucinous ovarian cancer (OvCa) in Caucasians. Whether a similar association exists in African Americans (AA) is unknown.

Methods

We conducted a population-based case–control study of incident OvCa in AA women across 11 geographic locations in the US. A structured telephone interview asked about smoking, demographic, health, and lifestyle factors. Odds ratios and 95% confidence intervals (OR, 95% CI) were estimated from 613 cases and 752 controls using unconditional logistic regression in multivariable adjusted models.

Results

Associations were greater in magnitude for serous OvCa than for all OvCa combined. Compared to never smokers, increased risk for serous OvCa was observed for lifetime ever smokers (1.46, 1.11–1.92), former smokers who quit within 0–2 years of diagnosis (5.48, 3.04–9.86), and for total pack-years smoked among lifetime ever smokers (0–5 pack-years: 1.79, 1.23–2.59; >5–20 pack-years: 1.52, 1.05–2.18; >20 pack-years: 0.98, 0.61–1.56); however, we observed no dose–response relationship with increasing duration or consumption and no significant associations among current smokers. Smoking was not significantly associated with mucinous OvCa. Associations for all OvCa combined were consistently elevated among former smokers. The proportion of ever smokers who quit within 0–2 years was greater among cases (23%) than controls (7%).

Conclusions

Cigarette smoking may be associated with serous OvCa among AA, which differs from associations reported among Caucasians. Exposure misclassification or reverse causality may partially explain the absence of increased risk among current smokers and lack of dose–response associations. Better characterization of smoking patterns is needed in this understudied population.

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Acknowledgments

We would like to acknowledge the AACES interviewers, Christine Bard, LaTonda Briggs, Whitney Franz (North Carolina), and Robin Gold (Detroit). We also acknowledge the individuals responsible for facilitating case ascertainment at the 11 geographic locations across the 10 study centers including Jennifer Burczyk-Brown (Alabama); Rana Bayakly and Vicki Bennett (Georgia); the Louisiana Tumor Registry; Manisha Narang (New Jersey); Diana Slone, Yingli Wolinsky, Steven Waggoner, Anne Heugel, Nancy Fusco, Kelly Ferguson, Peter Rose, Deb Strater, Taryn Ferber, Donna White, Lynn Borzi, Eric Jenison, Nairmeen Haller, Debbie Thomas, Vivian von Gruenigen, Michele McCarroll, Joyce Neading, John Geisler, Stephanie Smiddy, David Cohn, Michele Vaughan, Luis Vaccarello, Elayna Freese, James Pavelka, Pam Plummer, William Nahhas, Ellen Cato, John Moroney, Mark Wysong, Tonia Combs, Marci Bowling, Brandon Fletcher, Yingli Wolinsky (Ohio); Susan Bolick, Donna Acosta, Catherine Flanagan (South Carolina); Martin Whiteside (Tennessee) and Georgina Armstrong and the Texas Registry, Cancer Epidemiology and Surveillance Branch, Department of State Health Services.

Funding

The AACES study was funded by NCI (R01CA142081). Additional support was provided by Metropolitan Detroit Cancer Surveillance System (MDCSS) with federal funds from the National Cancer Institute, National Institute of Health, Dept. of Health and Human Services, under Contract No. HHSN261201000028C and the Epidemiology Research Core, supported in part by NCI Center Grant (P30CA22453) to the Karmanos Cancer Institute, Wayne State University School of Medicine, and NCI Center Grant (P30CA072720) to the Rutgers Cancer Institute of New Jersey. The funders had no role in the design, analysis, or writing of this article.

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Authors and Affiliations

  1. Department of Public Health Sciences, Medical University of South Carolina, Bioengineering Building, MSC955, 68 President Street, Charleston, SC, 29425, USA

    Linda E. Kelemen, Kristin Wallace & Anthony J. Alberg

  2. Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA

    Linda E. Kelemen, Kristin Wallace & Anthony J. Alberg

  3. Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA

    Sarah Abbott, Lauren Cole Peres & Joellen M. Schildkraut

  4. Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA

    Bo Qin & Elisa V. Bandera

  5. Department of Community and Family Medicine, Duke Cancer Institute, Durham, NC, USA

    Patricia G. Moorman

  6. Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA

    Jill S. Barnholtz-Sloan

  7. Department of Medicine, Section of Epidemiology and Population Sciences, Baylor College of Medicine, Houston, TX, USA

    Melissa Bondy

  8. College of Nursing, Medical University of South Carolina, Charleston, SC, USA

    Kathleen Cartmell

  9. Department of Oncology and the Karmanos Cancer Institute, Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI, USA

    Michele L. Cote & Ann G. Schwartz

  10. Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA

    Ellen Funkhouser

  11. Cancer Surveillance Research, Rutgers Cancer Institute of New Jersey and Rutgers School of Public Health, New Jersey State Cancer Registry, New Brunswick, NJ, USA

    Lisa E. Paddock

  12. Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA

    Edward S. Peters

  13. Departments of Public Health and Surgery, University of Tennessee-Knoxville, Knoxville, TN, USA

    Paul Terry

Authors
  1. Linda E. Kelemen
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  2. Sarah Abbott
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  3. Bo Qin
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  5. Patricia G. Moorman
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  6. Kristin Wallace
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  7. Elisa V. Bandera
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  8. Jill S. Barnholtz-Sloan
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  9. Melissa Bondy
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  10. Kathleen Cartmell
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  11. Michele L. Cote
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  12. Ellen Funkhouser
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  13. Lisa E. Paddock
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  14. Edward S. Peters
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  15. Ann G. Schwartz
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  16. Paul Terry
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  17. Anthony J. Alberg
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  18. Joellen M. Schildkraut
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Corresponding author

Correspondence to Linda E. Kelemen.

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Kelemen, L.E., Abbott, S., Qin, B. et al. Cigarette smoking and the association with serous ovarian cancer in African American women: African American Cancer Epidemiology Study (AACES). Cancer Causes Control 28, 699–708 (2017). https://doi.org/10.1007/s10552-017-0899-6

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  • DOI: https://doi.org/10.1007/s10552-017-0899-6

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