Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition

K. K. Tsilidis, N. E. Allen, T. J. Key, L. Dossus, A. Lukanova, K. Bakken, E. Lund, A. Fournier, K. Overvad, L. Hansen, A. Tjønneland, V. Fedirko, S. Rinaldi, I. Romieu, F. Clavel-Chapelon, P. Engel, R. Kaaks, M. Schütze, A. Steffen, C. BamiaA. Trichopoulou, D. Zylis, G. Masala, V. Pala, R. Galasso, R. Tumino, C. Sacerdote, H. B. Bueno-De-Mesquita, F. J B Van Duijnhoven, M. G M Braem, N. C. Onland-Moret, I. T. Gram, L. Rodríguez, N. Travier, M. J. Sánchez, J. M. Huerta, E. Ardanaz, N. Larrãaga, K. Jirström, J. Manjer, A. Idahl, N. Ohlson, K. T. Khaw, N. Wareham, T. Mouw, T. Norat, E. Riboli

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Abstract

Background: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. Methods: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. Results: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, 52 vs ≤45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. Conclusion: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors.

Original languageEnglish
Pages (from-to)1436-1442
Number of pages7
JournalBritish Journal of Cancer
Volume105
Issue number9
DOIs
Publication statusPublished - Oct 25 2011

Fingerprint

Oral Contraceptives
Ovarian Neoplasms
Neoplasms
Menarche
Confidence Intervals
Menopause
Parity
Pregnancy
Ovariectomy
Breast Feeding
Hysterectomy
Proportional Hazards Models
Body Mass Index
Smoking
Hormones

Keywords

  • cohort study
  • oral contraceptive use
  • ovarian cancer
  • reproductive history

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition. / Tsilidis, K. K.; Allen, N. E.; Key, T. J.; Dossus, L.; Lukanova, A.; Bakken, K.; Lund, E.; Fournier, A.; Overvad, K.; Hansen, L.; Tjønneland, A.; Fedirko, V.; Rinaldi, S.; Romieu, I.; Clavel-Chapelon, F.; Engel, P.; Kaaks, R.; Schütze, M.; Steffen, A.; Bamia, C.; Trichopoulou, A.; Zylis, D.; Masala, G.; Pala, V.; Galasso, R.; Tumino, R.; Sacerdote, C.; Bueno-De-Mesquita, H. B.; Van Duijnhoven, F. J B; Braem, M. G M; Onland-Moret, N. C.; Gram, I. T.; Rodríguez, L.; Travier, N.; Sánchez, M. J.; Huerta, J. M.; Ardanaz, E.; Larrãaga, N.; Jirström, K.; Manjer, J.; Idahl, A.; Ohlson, N.; Khaw, K. T.; Wareham, N.; Mouw, T.; Norat, T.; Riboli, E.

In: British Journal of Cancer, Vol. 105, No. 9, 25.10.2011, p. 1436-1442.

Research output: Contribution to journalArticle

Tsilidis, KK, Allen, NE, Key, TJ, Dossus, L, Lukanova, A, Bakken, K, Lund, E, Fournier, A, Overvad, K, Hansen, L, Tjønneland, A, Fedirko, V, Rinaldi, S, Romieu, I, Clavel-Chapelon, F, Engel, P, Kaaks, R, Schütze, M, Steffen, A, Bamia, C, Trichopoulou, A, Zylis, D, Masala, G, Pala, V, Galasso, R, Tumino, R, Sacerdote, C, Bueno-De-Mesquita, HB, Van Duijnhoven, FJB, Braem, MGM, Onland-Moret, NC, Gram, IT, Rodríguez, L, Travier, N, Sánchez, MJ, Huerta, JM, Ardanaz, E, Larrãaga, N, Jirström, K, Manjer, J, Idahl, A, Ohlson, N, Khaw, KT, Wareham, N, Mouw, T, Norat, T & Riboli, E 2011, 'Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition', British Journal of Cancer, vol. 105, no. 9, pp. 1436-1442. https://doi.org/10.1038/bjc.2011.371
Tsilidis, K. K. ; Allen, N. E. ; Key, T. J. ; Dossus, L. ; Lukanova, A. ; Bakken, K. ; Lund, E. ; Fournier, A. ; Overvad, K. ; Hansen, L. ; Tjønneland, A. ; Fedirko, V. ; Rinaldi, S. ; Romieu, I. ; Clavel-Chapelon, F. ; Engel, P. ; Kaaks, R. ; Schütze, M. ; Steffen, A. ; Bamia, C. ; Trichopoulou, A. ; Zylis, D. ; Masala, G. ; Pala, V. ; Galasso, R. ; Tumino, R. ; Sacerdote, C. ; Bueno-De-Mesquita, H. B. ; Van Duijnhoven, F. J B ; Braem, M. G M ; Onland-Moret, N. C. ; Gram, I. T. ; Rodríguez, L. ; Travier, N. ; Sánchez, M. J. ; Huerta, J. M. ; Ardanaz, E. ; Larrãaga, N. ; Jirström, K. ; Manjer, J. ; Idahl, A. ; Ohlson, N. ; Khaw, K. T. ; Wareham, N. ; Mouw, T. ; Norat, T. ; Riboli, E. / Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition. In: British Journal of Cancer. 2011 ; Vol. 105, No. 9. pp. 1436-1442.
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abstract = "Background: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. Methods: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95{\%} confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. Results: Women who used oral contraceptives for 10 or more years had a significant 45{\%} (HR, 0.55; 95{\%} CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, 52 vs ≤45 years: HR, 1.46; 95{\%} CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. Conclusion: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors.",
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T1 - Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition

AU - Tsilidis, K. K.

AU - Allen, N. E.

AU - Key, T. J.

AU - Dossus, L.

AU - Lukanova, A.

AU - Bakken, K.

AU - Lund, E.

AU - Fournier, A.

AU - Overvad, K.

AU - Hansen, L.

AU - Tjønneland, A.

AU - Fedirko, V.

AU - Rinaldi, S.

AU - Romieu, I.

AU - Clavel-Chapelon, F.

AU - Engel, P.

AU - Kaaks, R.

AU - Schütze, M.

AU - Steffen, A.

AU - Bamia, C.

AU - Trichopoulou, A.

AU - Zylis, D.

AU - Masala, G.

AU - Pala, V.

AU - Galasso, R.

AU - Tumino, R.

AU - Sacerdote, C.

AU - Bueno-De-Mesquita, H. B.

AU - Van Duijnhoven, F. J B

AU - Braem, M. G M

AU - Onland-Moret, N. C.

AU - Gram, I. T.

AU - Rodríguez, L.

AU - Travier, N.

AU - Sánchez, M. J.

AU - Huerta, J. M.

AU - Ardanaz, E.

AU - Larrãaga, N.

AU - Jirström, K.

AU - Manjer, J.

AU - Idahl, A.

AU - Ohlson, N.

AU - Khaw, K. T.

AU - Wareham, N.

AU - Mouw, T.

AU - Norat, T.

AU - Riboli, E.

PY - 2011/10/25

Y1 - 2011/10/25

N2 - Background: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. Methods: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. Results: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, 52 vs ≤45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. Conclusion: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors.

AB - Background: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. Methods: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327 396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. Results: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, 52 vs ≤45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. Conclusion: This study shows a strong protective association of oral contraceptives and parity with ovarian cancer risk, a higher risk with a late age at menopause, and no association with other reproductive factors.

KW - cohort study

KW - oral contraceptive use

KW - ovarian cancer

KW - reproductive history

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