title: Ovarian cancer risk factors by histologic subtypes in the NIH-AARP Diet and Health Study.
abstract: Data suggest that risk factors for ovarian carcinoma vary by histologic type, but findings are inconsistent. We prospectively evaluated risk factors by histological subtypes of incident ovarian cancer (n = 849) in a cohort of 169,391 women in the NIH-AARP Diet and Health Study. We constructed Cox models of individual exposures by comparing case subtypes to the entire non-case group and assessed p-heterogeneity in case-case comparisons using serous as the reference category. Substantial risk differences between histologic subtypes were observed for menopausal hormone therapy (MHT) use, oral contraceptive (OC) use, parity and body mass index (p-heterogeneity = 0.01, 0.03, 0.05, 0.03, respectively). MHT users were at increased risk for all histologic subtypes except for mucinous carcinomas, where risk was reduced (relative risk (RR) = 0.37; 95% confidence interval (CI): 0.18, 0.80). OC users were only at significantly decreased risk for serous cancers (RR = 0.69; 95% CI: 0.55, 0.85). Although parity was inversely associated with risk of all subtypes, the RRs ranged from 0.28 (clear cell) to 0.83 (serous). Obesity was a significant risk factor only for endometrioid cancers (RR = 1.64; 95% CI: 1.00, 2.70). Our findings support a link between etiological factors and histological heterogeneity in ovarian carcinoma.
authors.affiliation: Department of Health and Human Services, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. yanghan@mail.nih.gov
authors.forename: Hannah P
authors.initials: HP
authors.lastname: Yang
authors.forename: Britton
authors.initials: B
authors.lastname: Trabert
authors.forename: Megan A
authors.initials: MA
authors.lastname: Murphy
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
authors.forename: Joshua N
authors.initials: JN
authors.lastname: Sampson
authors.forename: Louise A
authors.initials: LA
authors.lastname: Brinton
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Albert
authors.initials: A
authors.lastname: Hollenbeck
authors.forename: Yikyung
authors.initials: Y
authors.lastname: Park
authors.forename: Nicolas
authors.initials: N
authors.lastname: Wentzensen
mesh_terms: D000368:Aged; D015992:Body Mass Index; D003278:Contraceptives, Oral, Hormonal; D015914:Estrogen Replacement Therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000473:pathology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D003278:Contraceptives, Oral, Hormonal