Parity,infertility, oral contraceptives,and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study |
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Authors: | Emma L Kaderly Rasmussen Charlotte Gerd Hannibal Christian Dehlendorff Louise Baandrup Jette Junge Russell Vang Robert J Kurman Susanne K Kjaer |
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Institution: | 1. Unit of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark;2. Unit of Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen, Denmark;3. Department of Pathology, Hvidovre Hospital, Kettegård Allé 30, 2650 Hvidovre, Denmark;4. Departments of Pathology, Gynecology and Obstetrics, The Johns Hopkins University School of Medicine, 401 North Broadway, Baltimore, MD 21231, USA;5. Departments of Gynecology/Obstetrics, Pathology and Oncology, The Johns Hopkins University School of Medicine, 401 North Broadway, Baltimore, MD 21231, USA;6. Department of Gynecology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100 Copenhagen, Denmark |
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Abstract: | ObjectiveFew studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim.MethodsThis nationwide case-control study included all women with an SBT diagnosis in Denmark, 1978–2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).ResultsWe found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (p < 0.01). Older age at first birth also decreased the SBT risk (p = 0.03). An increased SBT risk was associated with infertility (OR = 3.31; 95% CI: 2.44–4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR = 1.32; 95% CI: 1.02–1.72), whereas OC use decreased the risk (OR = 0.40; 95% CI: 0.26–0.62).ConclusionsOur nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors. |
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Keywords: | CI confidence interval ICD International Classification of Disease ICD-O-3 ICD for Oncology 3rd Edition OR odds ratio SBT ovarian serous borderline tumor Ovarian serous borderline tumor (SBT) Risk factor Parity Infertility Oral contraceptive (OC) Hormone replacement therapy (HRT) |
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