Ovarian cancer risk factors by tumor aggressiveness: An analysis from the Ovarian Cancer Cohort Consortium

Renee T. Fortner*, Elizabeth M. Poole, Nicolas A. Wentzensen, Britton Trabert, Emily White, Alan A. Arslan, Alpa Patel, V. Wendy Setiawan, Kala Visvanathan, Elisabete Weiderpass, Hans-Olov Adami, Amanda Black, Leslie Bernstein, Louise A. Brinton, Julie Buring, Tess Clendenen, Agnes Fournier, Gary Fraser, Susan M. Gapstur, Mia M. GaudetGraham G. Giles, Inger T. Gram, Patricia Hartge, Judith Hoffman-Bolton, Annika Idahl, Rudolf Kaaks, Victoria A. Kirsh, Synnove Knutsen, Woon-Puay Koh, James V. Lacey, I-Min Lee, Eva Lundin, Melissa A. Merritt, Roger L. Milne, N. Charlotte Onland-Moret, Ulrike Peters, Jenny N. Poynter, Sabina Rinaldi, Kim Robien, Thomas Rohan, Maria-Jose Sanchez, Catherine Schairer, Leo J. Schouten, Anne Tjonneland, Mary K. Townsend, Ruth C. Travis, Antonia Trichopoulou, Piet A. van den Brandt, Paolo Vineis, Lynne Wilkens, Alicja Wolk, Hannah P. Yang, Anne Zeleniuch-Jacquotte, Shelley S. Tworoger

*Corresponding author for this work

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Abstract

Ovarian cancer risk factors differ by histotype; however, within subtype, there is substantial variability in outcomes. We hypothesized that risk factor profiles may influence tumor aggressiveness, defined by time between diagnosis and death, independent of histology. Among 1.3 million women from 21 prospective cohorts, 4,584 invasive epithelial ovarian cancers were identified and classified as highly aggressive (death in = 35 vs. 20 to <25 kg/m(2), 1.93 [1.46-2.56] and current smoking (vs. never, 1.30 [1.07-1.57]) were associated with increased risk of highly aggressive disease. Results were similar within histotypes. Ovarian cancer risk factors may be directly associated with subtypes defined by tumor aggressiveness, rather than through differential effects on histology. Studies to assess biological pathways are warranted.

Original languageEnglish
Pages (from-to)58-69
Number of pages12
JournalInternational Journal of Cancer
Volume145
Issue number1
DOIs
Publication statusPublished - 1 Jul 2019

Keywords

  • ovarian cancer
  • risk factors
  • subtypes
  • aggressiveness
  • prospective cohort
  • BREAST-CANCER
  • POSTMENOPAUSAL WOMEN
  • ENDOMETRIAL CANCER
  • PROLACTIN LEVELS
  • SEX STEROIDS
  • SURVIVAL
  • CHEMOTHERAPY
  • OBESITY
  • ASSOCIATION
  • SMOKING

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