title: Cigarette smoking and risk of ovarian cancer: a pooled analysis of 21 case-control studies.
abstract: OBJECTIVE
  The majority of previous studies have observed an increased risk of mucinous ovarian tumors associated with cigarette smoking, but the association with other histological types is unclear. In a large pooled analysis, we examined the risk of epithelial ovarian cancer associated with multiple measures of cigarette smoking with a focus on characterizing risks according to tumor behavior and histology.
  
  
  METHODS
  We used data from 21 case-control studies of ovarian cancer (19,066 controls, 11,972 invasive and 2,752 borderline cases). Study-specific odds ratios (OR) and 95 % confidence intervals (CI) were obtained from logistic regression models and combined into a pooled odds ratio using a random effects model.
  
  
  RESULTS
  Current cigarette smoking increased the risk of invasive mucinous (OR = 1.31; 95 % CI: 1.03-1.65) and borderline mucinous ovarian tumors (OR = 1.83; 95 % CI: 1.39-2.41), while former smoking increased the risk of borderline serous ovarian tumors (OR = 1.30; 95 % CI: 1.12-1.50). For these histological types, consistent dose-response associations were observed. No convincing associations between smoking and risk of invasive serous and endometrioid ovarian cancer were observed, while our results provided some evidence of a decreased risk of invasive clear cell ovarian cancer.
  
  
  CONCLUSIONS
  Our results revealed marked differences in the risk profiles of histological types of ovarian cancer with regard to cigarette smoking, although the magnitude of the observed associations was modest. Our findings, which may reflect different etiologies of the histological types, add to the fact that ovarian cancer is a heterogeneous disease.
authors: Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
authors: Mette T
authors: MT
authors: Faber
authors: Susanne K
authors: SK
authors: Kjær
authors: Christian
authors: C
authors: Dehlendorff
authors: Jenny
authors: J
authors: Chang-Claude
authors: Klaus K
authors: KK
authors: Andersen
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authors: Høgdall
authors: Penelope M
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authors: Lurie
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authors: Modugno
authors: Robert P
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authors: Goode
authors: Brooke L
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authors: Vierkant
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authors: Daniel W
authors: DW
authors: Cramer
authors: Kathryn L
authors: KL
authors: Terry
authors: Allison F
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authors: Elisa V
authors: EV
authors: Bandera
authors: Sara H
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authors: Olson
authors: Melony
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authors: King
authors: Urmila
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authors: Chandran
authors: Lambertus A
authors: LA
authors: Kiemeney
authors: Leon F A G
authors: LF
authors: Massuger
authors: Anne M
authors: AM
authors: van Altena
authors: Sita H
authors: SH
authors: Vermeulen
authors: Louise
authors: L
authors: Brinton
authors: Nicolas
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authors: Wentzensen
authors: Jolanta
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authors: Lissowska
authors: Hannah P
authors: HP
authors: Yang
authors: Kirsten B
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authors: Moysich
authors: Kunle
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authors: Odunsi
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authors: Kasza
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authors: Honglin
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authors: Song
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authors: Pharaoh
authors: Mitul
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authors: Alice S
authors: AS
authors: Whittemore
authors: Valerie
authors: V
authors: McGuire
authors: Weiva
authors: W
authors: Sieh
authors: Rebecca
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authors: Sutphen
authors: Usha
authors: U
authors: Menon
authors: Simon A
authors: SA
authors: Gayther
authors: Susan J
authors: SJ
authors: Ramus
authors: Aleksandra
authors: A
authors: Gentry-Maharaj
authors: Celeste Leigh
authors: CL
authors: Pearce
authors: Anna H
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authors: Wu
authors: Malcolm C
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mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D055815:Young Adult