title: Reproductive factors and ovarian cancer risk in African-American women.
abstract: Reproductive characteristics, the most established ovarian cancer risk factors, differ markedly between African-American and white women. Studies in predominantly white populations suggest that associations between reproductive characteristics and ovarian cancer vary by timing of the events and menopause status. This analysis examined associations between number, duration, and timing of reproductive events and epithelial ovarian cancer among African-American women.
  
  
  
  Data from a multicenter case-control study of ovarian cancer in African-American women (641 cases/752 controls) were used to examine associations with oral contraceptive (OC) use and pregnancy characteristics. Odds ratios (ORs) and 95% confidence intervals (CIs) associated with reproductive characteristics were calculated with logistic regression models.
  
  
  
  OC use (OR = 0.7, 95% CI 0.5-0.9), parity (OR = 0.5, 95% CI 0.3-0.6), and breastfeeding for >12 months (OR = 0.3, 95% CI 0.2-0.5) were inversely associated with ovarian cancer. More recent pregnancies and OC use had stronger associations with ovarian cancer than pregnancies or OC use that occurred earlier in life, especially among premenopausal women.
  
  
  
  This study provides the first thorough documentation that pregnancy, breastfeeding, and OC use are inversely associated with ovarian cancer in African-American women, similar to what has been observed in white women. The associations with timing of the exposures suggest that these factors have both short- and long-term effects.
authors.affiliation: Department of Community and Family Medicine, Cancer Control and Population Sciences, Duke University School of Medicine, Durham, NC. Electronic address: patricia.moorman@duke.edu.
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Moorman
authors.affiliation: Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, Charleston.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Alberg
authors.affiliation: Department of Population Science, Rutgers Cancer Institute of New Jersey, New Brunswick.
authors.forename: Elisa V
authors.initials: EV
authors.lastname: Bandera
authors.affiliation: Department of Epidemiology and Biostatistics, Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH.
authors.forename: Jill
authors.initials: J
authors.lastname: Barnholtz-Sloan
authors.affiliation: Cancer Prevention and Population Sciences Program, Baylor College of Medicine, Houston, TX.
authors.forename: Melissa
authors.initials: M
authors.lastname: Bondy
authors.affiliation: Department of Oncology and the Karmanos Cancer Institute Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Michele L
authors.initials: ML
authors.lastname: Cote
authors.affiliation: Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham.
authors.forename: Ellen
authors.initials: E
authors.lastname: Funkhouser
authors.affiliation: Epidemiology Program, Louisiana State University Health Sciences Center School of Public Health, New Orleans.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Peters
authors.affiliation: Department of Oncology and the Karmanos Cancer Institute Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI.
authors.forename: Ann G
authors.initials: AG
authors.lastname: Schwartz
authors.affiliation: Department of Medicine, University of Tennessee Graduate School of Medicine, Knoxville.
authors.forename: Paul
authors.initials: P
authors.lastname: Terry
authors.affiliation: Department of Community and Family Medicine, Cancer Control and Population Sciences, Duke University School of Medicine, Durham, NC.
authors.forename: Sydnee
authors.initials: S
authors.lastname: Crankshaw
authors.affiliation: Department of Community and Family Medicine, Cancer Control and Population Sciences, Duke University School of Medicine, Durham, NC.
authors.forename: Frances
authors.initials: F
authors.lastname: Wang
authors.affiliation: Department of Public Health Sciences, University of Virginia, Charlottesville.
authors.forename: Joellen M
authors.initials: JM
authors.lastname: Schildkraut
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D001942:Breast Feeding / Q000706:statistics & numerical data*; D016022:Case-Control Studies; D016001:Confidence Intervals; D003276:Contraceptives, Oral / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000208:ethnology* / Q000209:etiology / Q000503:physiopathology; D010298:Parity; D011237:Predictive Value of Tests; D017584:Reproductive History; D018570:Risk Assessment; D014481:United States; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D003276:Contraceptives, Oral
keywords: African-Americans; Breastfeeding; Case-control study; Oral contraceptives; Ovarian cancer; Parity; Pregnancy