Oral contraceptive use and reproductive factors and risk of ovarian cancer in the European Prospective Investigation into Cancer and Nutrition

作者：Konstantinos K. Tsilidis, Naomi E. Allen, T.J.A. Key, Laure Dossus, A. Lukanova, Kjersti Sletten Bakken, Eiliv Lund, Agnès Fournier, Kim Overvad, Louise Hansen, Anne Marie Tjønneland, Veronika Fedirko, Sabina Rinaldi, Isabelle Romieu, Françoise Clavel‐Chapelon, Pierre Engel, Rudolf Kaaks, M Schütze, Annika Steffen, C. Bamia, Antonia Trichopoulou, Dimosthenis Zylis, Giovanna Masala, Valeria Maria Pala, Rocco Galasso, Rosario Tumino, Carlotta Sacerdote, H. Bas Bueno‐de‐Mesquita, Fränzel J.B. van Duijnhoven, Marieke G. M. Braem, N. Charlotte Onland‐Moret, Inger Torhild Gram, L. Rodríguez, Noémie Travier, María‐José Sánchez, José María Huerta, Eva Ardanáz, Nerea Larrañaga, Karin Jirström, Jonas Manjer, Annika Idahl, Nina Ohlson, K-T Khaw, Nicholas J. Wareham, T Mouw, Teresa Norat, Elio Ríboli · 发表于：British Journal of Cancer · 年份：2011 · DOI：10.1038/bjc.2011.371 · 被引用次数：219 · 研究领域：Ovarian cancer diagnosis and treatment、Cancer Risks and Factors、BRCA gene mutations in cancer

BACKGROUND: It is well established that parity and use of oral contraceptives reduce the risk of ovarian cancer, but the associations with other reproductive variables are less clear. METHODS: We examined the associations of oral contraceptive use and reproductive factors with ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition. Among 327,396 eligible women, 878 developed ovarian cancer over an average of 9 years. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard models stratified by centre and age, and adjusted for smoking status, body mass index, unilateral ovariectomy, simple hysterectomy, menopausal hormone therapy, and mutually adjusted for age at menarche, age at menopause, number of full-term pregnancies and duration of oral contraceptive use. RESULTS: Women who used oral contraceptives for 10 or more years had a significant 45% (HR, 0.55; 95% CI, 0.41-0.75) lower risk compared with users of 1 year or less (P-trend, <0.01). Compared with nulliparous women, parous women had a 29% (HR, 0.71; 95% CI, 0.59-0.87) lower risk, with an 8% reduction in risk for each additional pregnancy. A high age at menopause was associated with a higher risk of ovarian cancer (>52 vs ≤ 45 years: HR, 1.46; 95% CI, 1.06-1.99; P-trend, 0.02). Age at menarche, age at first full-term pregnancy, incomplete pregnancies and breastfeeding were not associated with risk. CONCLUSION: This study shows a strong protectiv...