Birth spacing and maternal risk of invasive epithelial ovarian cancer in a Swedish nationwide cohort |
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| Authors: | Inkyung Baik,Mats Lambe,Qin Liu,Lucy Chie,Sven Cnattingius,Lorelei A. Mucci,Tomas Riman,Anders Ekbom,Hans-Olov Adami,Chung-Cheng Hsieh |
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| Affiliation: | (1) Division of Biostatistics and Epidemiology, Cancer Center, University of Massachusetts Medical School, 364 Plantation Street, LRB# 427, Worcester, MA, USA;(2) Department of Cancer Biology, University of Massachusetts Medical School, 364 Plantation Street, LRB# 427, Worcester, MA, USA;(3) Korea University Ansan Hospital, College of Medicine, Korea University, Seoul, Republic of Korea;(4) Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden;(5) Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA;(6) Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;(7) Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA;(8) Center for Clinical Research, Dalarna, Sweden;(9) Department of Obstetrics and Gynecology, Falu Hospital, Falun, Sweden;(10) Program in Clinical Epidemiology, Karolinska Hospital, Stockholm, Sweden |
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| Abstract: | Objective Pregnancies reduce the risk of ovarian cancer, and among multiparous women, levels of circulating progesterone might be higher during pregnancies with wider birth spacing. We hypothesized that childbirth with wider birth spacing might reduce maternal risk of invasive epithelial ovarian cancer more than births with narrower spacing. Methods We conducted a case–control study nested in a nationwide cohort of Swedish women from 1961 to 2001. We selected five individually age-matched controls for each case of invasive epithelial ovarian cancer, and analysis for the effect of birth spacing was performed for 5,341 cases and 29,047 controls. We applied unconditional logistic regression analyses adjusting for age, ages at childbirth, educational level, area of residence, and gender of offspring. Results Relative risk of invasive epithelial ovarian cancer associated with each one-year increase in average birth spacing is 1.00 (95% CI = 0.98–1.01) among all women and 0.99 (0.98–1.01) among those born before 1935 and less likely to have used oral contraceptives. Further analyses on the biparous and triparous women did not find a consistent association between birth spacing and the risk of ovarian cancer. Conclusions Birth spacing is unlikely to be a major determinant underlying the protective effects of childbirth on ovarian cancer risk. |
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| Keywords: | Birth spacing Invasive epithelial ovarian cancer Progesterone |
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