Multiple miscarriages are associated with the risk of ovarian cancer: Results from the european prospective investigation into cancer and nutrition

Marieke G M Braem, N. Charlotte Onland-Moret, Leo J. Schouten, Roy F P M Kruitwagen, Annekatrin Lukanova, Naomi E. Allen, Petra A. Wark, Anne Tjønneland, Louise Hansen, Christina Marie Braüner, Kim Overvad, Françoise Clavel-Chapelon, Nathalie Chabbert-Buffet, Birgit Teucher, Anna Floegel, Heiner Boeing, Antonia Trichopoulou, George Adarakis, Maria Plada, Sabina RinaldiVeronika Fedirko, Isabelle Romieu, Valeria Pala, Rocco Galasso, Carlotta Sacerdote, Domenico Palli, Rosario Tumino, H. Bas Bueno-de-Mesquita, Inger Torhild Gram, Oxana Gavrilyuk, Eiliv Lund, Maria José Sánchez, Catalina Bonet, Maria Dolores Chirlaque, Nerea Larrañaga, Aurelio Barricarte Gurrea, Jose R. Quirós, Annika Idahl, Nina Ohlson, Eva Lundin, Karin Jirström, Salma Butt, Konstantinos K. Tsilidis, Kay Tee Khaw, Nick Wareham, Elio Riboli, Rudolf Kaaks, Petra H M Peeters

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR≥4vs.0: 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR≥4vs.0: 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR≥4vs.0: 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories.

Original languageEnglish
Article numbere37141
JournalPLoS One
Volume7
Issue number5
DOIs
Publication statusPublished - May 18 2012

Fingerprint

abortion (animals)
ovarian neoplasms
Induced Abortion
Spontaneous Abortion
Nutrition
Ovarian Neoplasms
induced abortion
nutrition
neoplasms
pregnancy
Pregnancy
Neoplasms
Multiple Pregnancy
Reproductive History
Pathology
Observational Studies
Life Style
observational studies
lifestyle
questionnaires

ASJC Scopus subject areas

  • Agricultural and Biological Sciences(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Braem, M. G. M., Onland-Moret, N. C., Schouten, L. J., Kruitwagen, R. F. P. M., Lukanova, A., Allen, N. E., ... Peeters, P. H. M. (2012). Multiple miscarriages are associated with the risk of ovarian cancer: Results from the european prospective investigation into cancer and nutrition. PLoS One, 7(5), [e37141]. https://doi.org/10.1371/journal.pone.0037141

Multiple miscarriages are associated with the risk of ovarian cancer : Results from the european prospective investigation into cancer and nutrition. / Braem, Marieke G M; Onland-Moret, N. Charlotte; Schouten, Leo J.; Kruitwagen, Roy F P M; Lukanova, Annekatrin; Allen, Naomi E.; Wark, Petra A.; Tjønneland, Anne; Hansen, Louise; Braüner, Christina Marie; Overvad, Kim; Clavel-Chapelon, Françoise; Chabbert-Buffet, Nathalie; Teucher, Birgit; Floegel, Anna; Boeing, Heiner; Trichopoulou, Antonia; Adarakis, George; Plada, Maria; Rinaldi, Sabina; Fedirko, Veronika; Romieu, Isabelle; Pala, Valeria; Galasso, Rocco; Sacerdote, Carlotta; Palli, Domenico; Tumino, Rosario; Bueno-de-Mesquita, H. Bas; Gram, Inger Torhild; Gavrilyuk, Oxana; Lund, Eiliv; Sánchez, Maria José; Bonet, Catalina; Chirlaque, Maria Dolores; Larrañaga, Nerea; Gurrea, Aurelio Barricarte; Quirós, Jose R.; Idahl, Annika; Ohlson, Nina; Lundin, Eva; Jirström, Karin; Butt, Salma; Tsilidis, Konstantinos K.; Khaw, Kay Tee; Wareham, Nick; Riboli, Elio; Kaaks, Rudolf; Peeters, Petra H M.

In: PLoS One, Vol. 7, No. 5, e37141, 18.05.2012.

Research output: Contribution to journalArticle

Braem, MGM, Onland-Moret, NC, Schouten, LJ, Kruitwagen, RFPM, Lukanova, A, Allen, NE, Wark, PA, Tjønneland, A, Hansen, L, Braüner, CM, Overvad, K, Clavel-Chapelon, F, Chabbert-Buffet, N, Teucher, B, Floegel, A, Boeing, H, Trichopoulou, A, Adarakis, G, Plada, M, Rinaldi, S, Fedirko, V, Romieu, I, Pala, V, Galasso, R, Sacerdote, C, Palli, D, Tumino, R, Bueno-de-Mesquita, HB, Gram, IT, Gavrilyuk, O, Lund, E, Sánchez, MJ, Bonet, C, Chirlaque, MD, Larrañaga, N, Gurrea, AB, Quirós, JR, Idahl, A, Ohlson, N, Lundin, E, Jirström, K, Butt, S, Tsilidis, KK, Khaw, KT, Wareham, N, Riboli, E, Kaaks, R & Peeters, PHM 2012, 'Multiple miscarriages are associated with the risk of ovarian cancer: Results from the european prospective investigation into cancer and nutrition', PLoS One, vol. 7, no. 5, e37141. https://doi.org/10.1371/journal.pone.0037141
Braem, Marieke G M ; Onland-Moret, N. Charlotte ; Schouten, Leo J. ; Kruitwagen, Roy F P M ; Lukanova, Annekatrin ; Allen, Naomi E. ; Wark, Petra A. ; Tjønneland, Anne ; Hansen, Louise ; Braüner, Christina Marie ; Overvad, Kim ; Clavel-Chapelon, Françoise ; Chabbert-Buffet, Nathalie ; Teucher, Birgit ; Floegel, Anna ; Boeing, Heiner ; Trichopoulou, Antonia ; Adarakis, George ; Plada, Maria ; Rinaldi, Sabina ; Fedirko, Veronika ; Romieu, Isabelle ; Pala, Valeria ; Galasso, Rocco ; Sacerdote, Carlotta ; Palli, Domenico ; Tumino, Rosario ; Bueno-de-Mesquita, H. Bas ; Gram, Inger Torhild ; Gavrilyuk, Oxana ; Lund, Eiliv ; Sánchez, Maria José ; Bonet, Catalina ; Chirlaque, Maria Dolores ; Larrañaga, Nerea ; Gurrea, Aurelio Barricarte ; Quirós, Jose R. ; Idahl, Annika ; Ohlson, Nina ; Lundin, Eva ; Jirström, Karin ; Butt, Salma ; Tsilidis, Konstantinos K. ; Khaw, Kay Tee ; Wareham, Nick ; Riboli, Elio ; Kaaks, Rudolf ; Peeters, Petra H M. / Multiple miscarriages are associated with the risk of ovarian cancer : Results from the european prospective investigation into cancer and nutrition. In: PLoS One. 2012 ; Vol. 7, No. 5.
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abstract = "While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR≥4vs.0: 1.74, 95{\%} CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR≥4vs.0: 1.99, 95{\%} CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR≥4vs.0: 1.46, 95{\%} CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories.",
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AU - Braem, Marieke G M

AU - Onland-Moret, N. Charlotte

AU - Schouten, Leo J.

AU - Kruitwagen, Roy F P M

AU - Lukanova, Annekatrin

AU - Allen, Naomi E.

AU - Wark, Petra A.

AU - Tjønneland, Anne

AU - Hansen, Louise

AU - Braüner, Christina Marie

AU - Overvad, Kim

AU - Clavel-Chapelon, Françoise

AU - Chabbert-Buffet, Nathalie

AU - Teucher, Birgit

AU - Floegel, Anna

AU - Boeing, Heiner

AU - Trichopoulou, Antonia

AU - Adarakis, George

AU - Plada, Maria

AU - Rinaldi, Sabina

AU - Fedirko, Veronika

AU - Romieu, Isabelle

AU - Pala, Valeria

AU - Galasso, Rocco

AU - Sacerdote, Carlotta

AU - Palli, Domenico

AU - Tumino, Rosario

AU - Bueno-de-Mesquita, H. Bas

AU - Gram, Inger Torhild

AU - Gavrilyuk, Oxana

AU - Lund, Eiliv

AU - Sánchez, Maria José

AU - Bonet, Catalina

AU - Chirlaque, Maria Dolores

AU - Larrañaga, Nerea

AU - Gurrea, Aurelio Barricarte

AU - Quirós, Jose R.

AU - Idahl, Annika

AU - Ohlson, Nina

AU - Lundin, Eva

AU - Jirström, Karin

AU - Butt, Salma

AU - Tsilidis, Konstantinos K.

AU - Khaw, Kay Tee

AU - Wareham, Nick

AU - Riboli, Elio

AU - Kaaks, Rudolf

AU - Peeters, Petra H M

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AB - While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR≥4vs.0: 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR≥4vs.0: 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR≥4vs.0: 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories.

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