Ovarian Cancer Risk Factor Associations by Primary Anatomic Site: The Ovarian Cancer Cohort Consortium
- 30 July 2020
- journal article
- research article
- Published by American Association for Cancer Research (AACR) in Cancer Epidemiology, Biomarkers & Prevention
- Vol. 29 (10), 2010-2018
- https://doi.org/10.1158/1055-9965.epi-20-0354
Abstract
Background: Epithelial ovarian, fallopian tube, and primary peritoneal cancer have shared developmental pathways. Few studies have prospectively examined heterogeneity in risk factor associations across these three anatomic sites. Methods: We identified 3,738 ovarian, 337 peritoneal, and 176 fallopian tube incident cancer cases in 891,731 women from 15 prospective cohorts in the Ovarian Cancer Cohort Consortium. Associations between 18 putative risk factors and risk of ovarian, peritoneal, and fallopian tube cancer, overall and for serous and high-grade serous tumors, were evaluated using competing risks Cox proportional hazards regression. Heterogeneity was assessed by likelihood ratio tests. Results: Most associations did not vary by tumor site (phet≥0.05). Associations between first pregnancy (phet=0.04), tubal ligation (phet=0.01) and early-adult (age 18-21 years) body mass index (BMI) (phet=0.02) and risk differed between ovarian and peritoneal cancers. The association between early adult BMI and risk further differed between peritoneal and fallopian tube cancer (phet=0.03). First pregnancy and tubal ligation were inversely associated with ovarian, but not peritoneal, cancer. Higher early-adult BMI was associated with higher risk of peritoneal, but not ovarian or fallopian tube, cancer. Patterns were generally similar when restricted to serous and high-grade serous cases. Conclusions: Ovarian, fallopian tube, and primary peritoneal cancers appear to have both shared and distinct etiologic pathways, although most risk factors appear to have similar associations by anatomic site. Impact: Further studies on the mechanisms underlying the differences in risk profiles may provide insights regarding the developmental origins of tumors arising in the peritoneal cavity and inform prevention efforts.Funding Information
- Centers for Disease Control and Prevention (NU58DP006333)
- Department of Defense Ovarian Cancer Research (W81XWH-12-1-0561)
- NCI Office of Dietary Supplements (K05 CA154337)
- Iowa Women's Health Study (R01 CA39742)
- Nurses' Health Study (R01 CA39742, UM1 CA186107, P01 CA87969, UM1 CA176726, R01 CA67262)
- NIH (UM1 CA182934)
- NYU Women's Health Study (P30 CA016087, P30 ES000260)
- NCI Intramural Research Program National Institute of Environmental Health Sciences (Z01-ES044005)
- Health Research Fund (PI13/00061, PI13/01162)
- ISCIII (RD06/0020)
- Cancer Research UK (C570/A16491, C8221/A19170)
- Medical Research Council (1000143, MR/M012190/1)
- Australian National Health Medical Research Council Cancer Council Victoria (209057, 396414, 1074383)
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