title: Infertility and risk of fatal ovarian cancer in a prospective cohort of US women.
abstract: OBJECTIVE
  It is difficult to separate the possible role of fertility drugs from underlying infertility as risk factors for ovarian cancer. The present study examined the relationship between self-reported infertility and death from ovarian cancer among married women unlikely to have been exposured to fertility drugs.
  
  
  METHODS
  Women were selected for study from the 676,526 female participants in Cancer Prevention Study II (CPS-II). After twelve years of follow-up, 797 deaths from ovarian cancer were observed among women with no prior history of cancer or hysterectomy and 40 years of age or older in 1967 when ovulatory stimulants were approved in the United States. Cox proportional hazards modeling was used to compute rate ratios (RRs) and to adjust for other potential risk factors.
  
  
  RESULTS
  Overall, self-reported infertility was not significantly associated with ovarian cancer mortality (adjusted rate ratio (RR) = 1.1, 95 percent confidence interval (CI) = 0.9-1.3). Ovarian cancer death rates among nulligravid women with self-reported infertility, however, were 40 percent higher than for nulligravid women who never tried to become pregnant (RR = 1.4, 95 percent CI = 0.9-2.4). Multigravid women who reported infertility problems were not at increased risk.
  
  
  CONCLUSIONS
  These results suggest that infertility itself, without concomitant exposure to fertility drugs, may increase risk of fatal ovarian cancer among nulligravid women.
authors: Department of Epidemiology and Surveillance Research, American Cancer Society, Atlanta, GA 30329-4251, USA.
authors: C
authors: C
authors: Rodriguez
authors: L M
authors: LM
authors: Tatham
authors: E E
authors: EE
authors: Calle
authors: M J
authors: MJ
authors: Thun
authors: E J
authors: EJ
authors: Jacobs
authors: C W
authors: CW
authors: Heath
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D005300:Fertility Agents, Female / Q000009:adverse effects*; D005500:Follow-Up Studies; D006801:Humans; D007246:Infertility / Q000453:epidemiology*; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000209:etiology* / Q000401:mortality*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D005300:Fertility Agents, Female