title: Risk factors for ovarian cancers with and without microsatellite instability.
abstract: OBJECTIVE
  In a population-based sample of epithelial ovarian cancers, the objective of this study was to evaluate the association between microsatellite instability (MSI) status and the following factors: (1) ovarian cancer risk factors and (2) the distribution of the specific histologic subtypes.
  
  
  METHODS
  Participants were drawn from 3 population-based studies of primary epithelial ovarian cancer; tumor DNA was analyzed using 5 standardized microsatellite markers to assess the MSI status. Patients were divided into 3 groups (MSI-high, MSI-low, and MSI-stable) according to the National Cancer Institute criteria. We compared the prevalence of specific known risk and protective factors among the 3 subgroups, including body mass index, smoking history, parity, BRCA1 and BRCA2 mutation status, past oral contraceptive use, and tubal ligation. Similarly, we compared the distribution of the histologic subtypes among the 3 subgroups.
  
  
  RESULTS
  A total of 917 ovarian cancer patients were included. One hundred twenty-seven cases of cancer (13.8%) were MSI-high. Subgroup analyses according to smoking, body mass index, parity, past oral contraceptive use, and past tubal ligation did not reveal any statistically significance differences among the groups. Among the 29 patients with BRCA1 mutations, 20.7% had MSI-high cancers compared with 5.9% among 17 patients with BRCA2 mutations. The proportions of different ovarian cancer histologies among the various MSI subgroups were similar.
  
  
  CONCLUSIONS
  The prevalence of risk and protective factors among ovarian cancer patients is similar for cancers with and without MSI. The distributions of MSI do not differ significantly among ovarian cancers with different histologies. Ovarian cancer patients with BRCA1 mutations had a 21% rate of MSI-high tumors compared with 6% among patients with BRCA2 mutations, but this difference was not statistically significant.
authors.affiliation: *Familial Breast Cancer Research, Women's College Research Institute; †Department of Obstetrics and Gynecology, University of Toronto; ‡Department of Gynecologic Oncology, Princess Margaret Hospital; §Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada; ∥Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center, Tampa, FL; ¶Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT; and #Duke University, Duke School of Medicine, Durham, NC.
authors.forename: Yakir
authors.initials: Y
authors.lastname: Segev
authors.forename: Tuya
authors.initials: T
authors.lastname: Pal
authors.forename: Barry
authors.initials: B
authors.lastname: Rosen
authors.forename: John R
authors.initials: JR
authors.lastname: McLaughlin
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Sellers
authors.forename: Harvey A
authors.initials: HA
authors.lastname: Risch
authors.forename: Shiyu
authors.initials: S
authors.lastname: Zhang
authors.forename: Ping
authors.initials: P
authors.lastname: Sun
authors.forename: Steven A
authors.initials: SA
authors.lastname: Narod
authors.forename: Joellen
authors.initials: J
authors.lastname: Schildkraut
mesh_terms: D018262:Adenocarcinoma, Clear Cell / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D002288:Adenocarcinoma, Mucinous / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D019313:BRCA1 Protein / Q000235:genetics; D024682:BRCA2 Protein / Q000235:genetics; D001943:Breast Neoplasms / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D002170:Canada / Q000453:epidemiology; D018284:Cystadenocarcinoma, Serous / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D004273:DNA, Neoplasm / Q000235:genetics; D016889:Endometrial Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D053842:Microsatellite Instability; D018895:Microsatellite Repeats; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D011379:Prognosis; D012307:Risk Factors; D013577:Syndrome; D014481:United States / Q000453:epidemiology
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human; D004273:DNA, Neoplasm