Ovarian Cancer Risk Factors by Histologic Subtype: An Analysis From the Ovarian Cancer Cohort Consortium

Nicolas Wentzensen*, Elizabeth M. Poole, Britton Trabert, Emily White, Alan A. Arslan, Alpa V. Patel, V. Wendy Setiawan, Kala Visvanathan, Elisabete Weiderpass, Hans-Olov Adami, Amanda Black, Leslie Bernstein, Louise A. Brinton, Julie Buring, Lesley M. Butler, Saioa Chamosa, Tess V. Clendenen, Laure Dossus, Renee Fortner, Susan M. GapsturMia M. Gaudet, Inger T. Gram, Patricia Hartge, Judith Hoffman-Bolton, Annika Idahl, Michael Jones, Rudolf Kaaks, Victoria Kirsh, Woon-Puay Koh, James V., Jr. Lacey, I-Min Lee, Eva Lundin, Melissa A. Merritt, N. Charlotte Onland-Moret, Ulrike Peters, Jenny N. Poynter, Sabina Rinaldi, Kim Robien, Thomas Rohan, Dale P. Sandler, Catherine Schairer, Leo J. Schouten, Louise K. Sjoholm, Sabina Sieri, Anthony Swerdlow, Anna Tjonneland, Ruth Travis, Antonia Trichopoulou, Piet A. van den Brandt, Lynne Wilkens, Alicja Wolk, Hannah P. Yang, Anne Zeleniuch-Jacquotte, Shelley S. Tworoger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Purpose An understanding of the etiologic heterogeneity of ovarian cancer is important for improving prevention, early detection, and therapeutic approaches. We evaluated 14 hormonal, reproductive, and lifestyle factors by histologic subtype in the Ovarian Cancer Cohort Consortium (OC3). Patients and Methods Among 1.3 million women from 21 studies, 5,584 invasive epithelial ovarian cancers were identified (3,378 serous, 606 endometrioid, 331 mucinous, 269 clear cell, 1,000 other). By using competing risks Cox proportional hazards regression stratified by study and birth year and adjusted for age, parity, and oral contraceptive use, we assessed associations for all invasive cancers by histology. Heterogeneity was evaluated by likelihood ratio test. Results Most risk factors exhibited significant heterogeneity by histology. Higher parity was most strongly associated with endometrioid (relative risk [RR] per birth, 0.78; 95% CI, 0.74 to 0.83) and clear cell (RR, 0.68; 95% CI, 0.61 to 0.76) carcinomas (P value for heterogeneity [P-het] <.001). Similarly, age at menopause, endometriosis, and tubal ligation were only associated with endometrioid and clear cell tumors (P-het
Original languageEnglish
Pages (from-to)2888-2898
JournalJournal of Clinical Oncology
Issue number24
Publication statusPublished - 20 Aug 2016

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