Offspring sex and risk of epithelial ovarian cancer: a multinational pooled analysis of 12 case–control studies
- 21 September 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in European Journal of Epidemiology
- Vol. 35 (11), 1025-1042
- https://doi.org/10.1007/s10654-020-00682-9
Abstract
While childbearing protects against risk of epithelial ovarian cancer (EOC), few studies have explored the impact on maternal EOC risk of sex of offspring, which may affect the maternal environment during pregnancy. We performed a pooled analysis among parous participants from 12 case–controls studies comprising 6872 EOC patients and 9101 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression for case–control associations and polytomous logistic regression for histotype-specific associations, all adjusted for potential confounders. In general, no associations were found between offspring sex and EOC risk. However, compared to bearing only female offspring, bearing one or more male offspring was associated with increased risk of mucinous EOC (OR = 1.45; 95% CI = 1.01-2.07), which appeared to be limited to women reporting menarche before age 13 compared to later menarche (OR = 1.71 vs 0.99; P-interaction = 0.02). Bearing increasing numbers of male offspring was associated with greater risks of mucinous tumors (OR = 1.31, 1.84, 2.31, for 1, 2 and 3 or more male offspring, respectively; trend-p = 0.005). Stratifying by hormonally-associated conditions suggested that compared to bearing all female offspring, bearing a male offspring was associated with lower risk of endometrioid cancer among women with a history of adult acne, hirsutism, or polycystic ovary syndrome (OR = 0.49, 95% CI = 0.28-0.83) but with higher risk among women without any of those conditions (OR = 1.64 95% CI = 1.14–2.34; P-interaction = 0.003). Offspring sex influences the childbearing-EOC risk relationship for specific histotypes and conditions. These findings support the differing etiologic origins of EOC histotypes and highlight the importance of EOC histotype-specific epidemiologic studies. These findings also suggest the need to better understand how pregnancy affects EOC riskKeywords
This publication has 81 references indexed in Scilit:
- Association between endometriosis and risk of histological subtypes of ovarian cancer: a pooled analysis of case–control studiesThe Lancet Oncology, 2012
- Aspirin, Nonaspirin Nonsteroidal Anti-inflammatory Drugs, or Acetaminophen and Risk of Ovarian CancerEpidemiology, 2012
- Determinants of Maternal Sex Steroids During the First Half of PregnancyObstetrics & Gynecology, 2011
- Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer—Shifting the paradigmHuman Pathology, 2011
- Changes in pre-diagnostic serum C-reactive protein concentrations and ovarian cancer risk: a longitudinal studyAnnals of Oncology, 2011
- Ovarian CancerAnnual review of pathology, 2009
- Association of two common single-nucleotide polymorphisms in the CYP19A1 locus and ovarian cancer riskEndocrine-Related Cancer, 2008
- Consortium analysis of 7 candidate SNPs for ovarian cancerInternational Journal of Cancer, 2008
- Twin births, sex of children and maternal risk of ovarian cancer: a cohort study in NorwayBritish Journal of Cancer, 2007
- Endocrine characteristics of adolescent menstrual cycles: Impact of early menarcheJournal of Steroid Biochemistry, 1984