Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study

Jelena Be͉ević, Marc J. Gunter, Renee T. Fortner, Konstantinos K. Tsilidis, Elisabete Weiderpass, N. Charlotte Onland-Moret, Laure Dossus, Anne TjØnneland, Louise Hansen, Kim Overvad, Sylvie Mesrine, Laura Baglietto, Francoise Clavel-Chapelon, Rudolf Kaaks, Krasimira Aleksandrova, Heiner Boeing, Antonia Trichopoulou, Pagona Lagiou, Christina Bamia, Giovanna MasalaClaudia Agnoli, Rosario Tumino, Fulvio Ricceri, Salvatore Panico, H. B. Bueno-de-Mesquita, Petra H. Peeters, Mie Jareid, J. Ramon Quirós, Eric J. Duell, Maria Jose Sánchez, Nerea Larrañaga, Maria Dolores Chirlaque, Aurelio Barricarte, Joana A. Dias, Emily Sonestedt, Annika Idahl, Eva Lundin, Nicholas J. Wareham, Kay Tee Khaw, Ruth C. Travis, Sabina Rinaldi, Isabelle Romieu, Elio Riboli, Melissa A. Merritt

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background:Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25-70 years at recruitment from 1992 to 2000.Methods:Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.Results:After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR=0.80, 95% CI=0.62-1.03) and a significant survival benefit in long-term MHT users (≥5 years use vs never use, HR=0.70, 95% CI=0.50-0.99, P trend =0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk.Conclusions:Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.

Original languageEnglish
Pages (from-to)1622-1631
Number of pages10
JournalBritish Journal of Cancer
Volume113
Issue number11
DOIs
Publication statusPublished - Dec 1 2015

Fingerprint

Cohort Studies
Survival
Neoplasms
Hormones
Confidence Intervals
Menarche
Therapeutics
Oral Contraceptives
Menopause
Parity
Ovarian epithelial cancer
Breast Feeding
Proportional Hazards Models
Body Mass Index
Smoking
Mortality

Keywords

  • epithelial ovarian cancer
  • menopausal hormone therapy
  • oral contraceptives
  • parity
  • survival

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Be͉ević, J., Gunter, M. J., Fortner, R. T., Tsilidis, K. K., Weiderpass, E., Onland-Moret, N. C., ... Merritt, M. A. (2015). Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. British Journal of Cancer, 113(11), 1622-1631. https://doi.org/10.1038/bjc.2015.377

Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. / Be͉ević, Jelena; Gunter, Marc J.; Fortner, Renee T.; Tsilidis, Konstantinos K.; Weiderpass, Elisabete; Onland-Moret, N. Charlotte; Dossus, Laure; TjØnneland, Anne; Hansen, Louise; Overvad, Kim; Mesrine, Sylvie; Baglietto, Laura; Clavel-Chapelon, Francoise; Kaaks, Rudolf; Aleksandrova, Krasimira; Boeing, Heiner; Trichopoulou, Antonia; Lagiou, Pagona; Bamia, Christina; Masala, Giovanna; Agnoli, Claudia; Tumino, Rosario; Ricceri, Fulvio; Panico, Salvatore; Bueno-de-Mesquita, H. B.; Peeters, Petra H.; Jareid, Mie; Quirós, J. Ramon; Duell, Eric J.; Sánchez, Maria Jose; Larrañaga, Nerea; Chirlaque, Maria Dolores; Barricarte, Aurelio; Dias, Joana A.; Sonestedt, Emily; Idahl, Annika; Lundin, Eva; Wareham, Nicholas J.; Khaw, Kay Tee; Travis, Ruth C.; Rinaldi, Sabina; Romieu, Isabelle; Riboli, Elio; Merritt, Melissa A.

In: British Journal of Cancer, Vol. 113, No. 11, 01.12.2015, p. 1622-1631.

Research output: Contribution to journalArticle

Be͉ević, J, Gunter, MJ, Fortner, RT, Tsilidis, KK, Weiderpass, E, Onland-Moret, NC, Dossus, L, TjØnneland, A, Hansen, L, Overvad, K, Mesrine, S, Baglietto, L, Clavel-Chapelon, F, Kaaks, R, Aleksandrova, K, Boeing, H, Trichopoulou, A, Lagiou, P, Bamia, C, Masala, G, Agnoli, C, Tumino, R, Ricceri, F, Panico, S, Bueno-de-Mesquita, HB, Peeters, PH, Jareid, M, Quirós, JR, Duell, EJ, Sánchez, MJ, Larrañaga, N, Chirlaque, MD, Barricarte, A, Dias, JA, Sonestedt, E, Idahl, A, Lundin, E, Wareham, NJ, Khaw, KT, Travis, RC, Rinaldi, S, Romieu, I, Riboli, E & Merritt, MA 2015, 'Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study', British Journal of Cancer, vol. 113, no. 11, pp. 1622-1631. https://doi.org/10.1038/bjc.2015.377
Be͉ević J, Gunter MJ, Fortner RT, Tsilidis KK, Weiderpass E, Onland-Moret NC et al. Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. British Journal of Cancer. 2015 Dec 1;113(11):1622-1631. https://doi.org/10.1038/bjc.2015.377
Be͉ević, Jelena ; Gunter, Marc J. ; Fortner, Renee T. ; Tsilidis, Konstantinos K. ; Weiderpass, Elisabete ; Onland-Moret, N. Charlotte ; Dossus, Laure ; TjØnneland, Anne ; Hansen, Louise ; Overvad, Kim ; Mesrine, Sylvie ; Baglietto, Laura ; Clavel-Chapelon, Francoise ; Kaaks, Rudolf ; Aleksandrova, Krasimira ; Boeing, Heiner ; Trichopoulou, Antonia ; Lagiou, Pagona ; Bamia, Christina ; Masala, Giovanna ; Agnoli, Claudia ; Tumino, Rosario ; Ricceri, Fulvio ; Panico, Salvatore ; Bueno-de-Mesquita, H. B. ; Peeters, Petra H. ; Jareid, Mie ; Quirós, J. Ramon ; Duell, Eric J. ; Sánchez, Maria Jose ; Larrañaga, Nerea ; Chirlaque, Maria Dolores ; Barricarte, Aurelio ; Dias, Joana A. ; Sonestedt, Emily ; Idahl, Annika ; Lundin, Eva ; Wareham, Nicholas J. ; Khaw, Kay Tee ; Travis, Ruth C. ; Rinaldi, Sabina ; Romieu, Isabelle ; Riboli, Elio ; Merritt, Melissa A. / Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study. In: British Journal of Cancer. 2015 ; Vol. 113, No. 11. pp. 1622-1631.
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abstract = "Background:Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25-70 years at recruitment from 1992 to 2000.Methods:Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95{\%} confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.Results:After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9{\%}) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR=0.80, 95{\%} CI=0.62-1.03) and a significant survival benefit in long-term MHT users (≥5 years use vs never use, HR=0.70, 95{\%} CI=0.50-0.99, P trend =0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk.Conclusions:Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.",
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T1 - Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study

AU - Be͉ević, Jelena

AU - Gunter, Marc J.

AU - Fortner, Renee T.

AU - Tsilidis, Konstantinos K.

AU - Weiderpass, Elisabete

AU - Onland-Moret, N. Charlotte

AU - Dossus, Laure

AU - TjØnneland, Anne

AU - Hansen, Louise

AU - Overvad, Kim

AU - Mesrine, Sylvie

AU - Baglietto, Laura

AU - Clavel-Chapelon, Francoise

AU - Kaaks, Rudolf

AU - Aleksandrova, Krasimira

AU - Boeing, Heiner

AU - Trichopoulou, Antonia

AU - Lagiou, Pagona

AU - Bamia, Christina

AU - Masala, Giovanna

AU - Agnoli, Claudia

AU - Tumino, Rosario

AU - Ricceri, Fulvio

AU - Panico, Salvatore

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

AU - Peeters, Petra H.

AU - Jareid, Mie

AU - Quirós, J. Ramon

AU - Duell, Eric J.

AU - Sánchez, Maria Jose

AU - Larrañaga, Nerea

AU - Chirlaque, Maria Dolores

AU - Barricarte, Aurelio

AU - Dias, Joana A.

AU - Sonestedt, Emily

AU - Idahl, Annika

AU - Lundin, Eva

AU - Wareham, Nicholas J.

AU - Khaw, Kay Tee

AU - Travis, Ruth C.

AU - Rinaldi, Sabina

AU - Romieu, Isabelle

AU - Riboli, Elio

AU - Merritt, Melissa A.

PY - 2015/12/1

Y1 - 2015/12/1

N2 - Background:Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25-70 years at recruitment from 1992 to 2000.Methods:Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.Results:After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR=0.80, 95% CI=0.62-1.03) and a significant survival benefit in long-term MHT users (≥5 years use vs never use, HR=0.70, 95% CI=0.50-0.99, P trend =0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk.Conclusions:Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.

AB - Background:Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25-70 years at recruitment from 1992 to 2000.Methods:Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.Results:After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR=0.80, 95% CI=0.62-1.03) and a significant survival benefit in long-term MHT users (≥5 years use vs never use, HR=0.70, 95% CI=0.50-0.99, P trend =0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk.Conclusions:Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.

KW - epithelial ovarian cancer

KW - menopausal hormone therapy

KW - oral contraceptives

KW - parity

KW - survival

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