title: Cigarette smoking and risk of histological subtypes of epithelial ovarian cancer in the EPIC cohort study.
abstract: New data regarding a positive association between smoking and risk of epithelial ovarian cancer (EOC), especially the mucinous tumor type, has started to emerge. The purpose of this study was to examine the association between different measures of smoking exposures and subtypes of EOC in a large cohort of women from 10 European countries. The European Prospective Investigation into Cancer and Nutrition (EPIC) cohort is a multicenter prospective study initiated in 1992. The questionnaires included data about dietary, lifestyle, and health factors. Information about cigarette smoking was collected from individuals in all participating countries. We used Cox proportional hazard regression models to estimate hazard ratio (HR) of EOC overall and serous, mucinous, and endometroid histological subtypes, with 95% confidence intervals (CIs) associated with different measures of smoking exposures adjusting for confounding variables. Altogether 836 incident EOC cases were identified among 326,831 women. The tumors were classified as 400 serous, 83 mucinous, 80 endometroid, 35 clear cell, and 238 unspecified. Compared with never smokers, current smokers had a significantly increased risk for mucinous tumors [HR = 1.85 (95% CI 1.08-3.16)] and those smoking more than 10 cigarettes per day had a doubling in risk [HR = 2.25(95% CI 1.26-4.03)] as did those who had smoked less than 15 pack-years of cigarettes [HR = 2.18 (95% CI 1.07-4.43)]. The results from the EPIC study add further evidence that smoking increases risk of mucinous ovarian cancer and support the notion that the effect of smoking varies according to histological subtype.
authors.affiliation: Institute of Community Medicine, Faculty of Health Sciences, University of Tromsø, Tromsø, Norway. inger.gram@uit.no
authors.forename: Inger T
authors.initials: IT
authors.lastname: Gram
authors.forename: Annekatrin
authors.initials: A
authors.lastname: Lukanova
authors.forename: Ilene
authors.initials: I
authors.lastname: Brill
authors.forename: Tonje
authors.initials: T
authors.lastname: Braaten
authors.forename: Eiliv
authors.initials: E
authors.lastname: Lund
authors.forename: Eva
authors.initials: E
authors.lastname: Lundin
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Francoise
authors.initials: F
authors.lastname: Clavel-Chapelon
authors.forename: Nathalie
authors.initials: N
authors.lastname: Chabbert-Buffet
authors.forename: Christina
authors.initials: C
authors.lastname: Bamia
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Zylis
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.forename: Franco
authors.initials: F
authors.lastname: Berrino
authors.forename: Rocco
authors.initials: R
authors.lastname: Galasso
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.forename: Oxana
authors.initials: O
authors.lastname: Gavrilyuk
authors.forename: Steinar
authors.initials: S
authors.lastname: Kristiansen
authors.forename: Laudina
authors.initials: L
authors.lastname: Rodríguez
authors.forename: Catalina
authors.initials: C
authors.lastname: Bonet
authors.forename: José María
authors.initials: JM
authors.lastname: Huerta
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Maria-José
authors.initials: MJ
authors.lastname: Sánchez
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Karin
authors.initials: K
authors.lastname: Jirström
authors.forename: Martin
authors.initials: M
authors.lastname: Almquist
authors.forename: Annika
authors.initials: A
authors.lastname: Idahl
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.forename: Marie
authors.initials: M
authors.lastname: Braem
authors.forename: Charlotte
authors.initials: C
authors.lastname: Onland-Moret
authors.forename: Konstantinos K
authors.initials: KK
authors.lastname: Tsilidis
authors.forename: Naomi E
authors.initials: NE
authors.lastname: Allen
authors.forename: Veronika
authors.initials: V
authors.lastname: Fedirko
authors.forename: E
authors.initials: E
authors.lastname: Riboli
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kaaks
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D000328:Adult; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires