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Lifetime number of ovulatory cycles and epithelial ovarian cancer risk in African American women

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Abstract

Purpose

Incessant ovulation has been consistently linked to epithelial ovarian cancer (EOC). Although reproductive characteristics differ substantially by race, the association between incessant ovulation and EOC has been evaluated only in populations of predominantly white women. In the present study, we examined the association between lifetime number of ovulatory cycles (LOCs) and EOC risk among African American (AA) women.

Methods

We used data from 534 cases and 722 controls enrolled in the African American Cancer Epidemiology Study. LOCs were determined using the standard method, with modifications to include episodes of irregular or missed periods. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between LOCs and EOC risk overall and by age, while adjusting for appropriate confounders.

Results

The mean number of LOCs was 378.2 ± 105.8 for cases and 346.4 ± 117.3 for controls. Women in the highest tertile of LOCs had 59% higher odds of EOC compared to women in the lowest tertile (OR = 1.59; 95% CI = 1.15–2.20). When examining this relationship by age, the positive association with EOC was stronger among women <50 years of age (OR for highest vs. lowest tertile = 2.61; 95% CI = 1.15–5.94), followed by women aged 50–60 years (OR = 2.27; 95% CI = 1.30–3.94). Yet, no association was present among women aged >60 years (OR = 0.79; 95% CI = 0.45–1.40).

Conclusions

In a population of AA women, we observed a positive association between LOCs and EOC risk, providing further support for the hypothesis that incessant ovulation contributes to the etiology of EOC.

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Acknowledgments

This study was supported by the National Cancer Institute (R01CA142081). Additional support was provided by the Metropolitan Detroit Cancer Surveillance System with funding from the National Cancer Institute, National Institute of Health, and the Department of Health and Human Services (Contract HHSN261201000028C), and the Epidemiology Research Core, supported in part by the National Cancer Institute (P30CA22453) to the Karmanos Cancer Institute, Wayne State University School of Medicine. The New Jersey State Cancer Registry, Cancer Epidemiology Services, New Jersey Department of Health, is funded by the Surveillance, Epidemiology and End Results (SEER) Program of the National Cancer Institute under contract HHSN261201300021I, the National Program of Cancer Registries (NPCR), Centers for Disease Control and Prevention under grant 5U58DP003931-02 as well as the State of New Jersey and the Rutgers Cancer Institute of New Jersey. The authors are grateful for the AACES interviewers, Christine Bard, LaTonda Briggs, Whitney Franz (North Carolina) and Robin Gold (Detroit). We would also like to acknowledge the individuals responsible for facilitating case ascertainment across the ten sites including: Jennifer Burczyk-Brown (Alabama); Rana Bayakly, Vicki Bennett and Judy Andrews (Georgia); the Louisiana Tumor Registry; Lisa Paddock, Natalia Herman and Manisha Narang (New Jersey); Diana Slone, Yingli Wolinsky, Steven Waggoner, Anne Heugel, Nancy Fusco, Kelly Ferguson, Peter Rose, Deb Strater, Taryn Ferber, Donna White, Lynn Borzi, Eric Jenison, Nairmeen Haller, Debbie Thomas, Vivian von Gruenigen, Michele McCarroll, Joyce Neading, John Geisler, Stephanie Smiddy, David Cohn, Michele Vaughan, Luis Vaccarello, Elayna Freese, James Pavelka, Pam Plummer, William Nahhas, Ellen Cato, John Moroney, Mark Wysong, Tonia Combs, Marci Bowling, Brandon Fletcher (Ohio); Susan Bolick, Donna Acosta, Catherine Flanagan (South Carolina); Martin Whiteside (Tennessee) and Georgina Armstrong and the Texas Registry, Cancer Epidemiology and Surveillance Branch, Department of State Health Services.

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Authors and Affiliations

  1. Department of Public Health Sciences, University of Virginia, 800765, Charlottesville, VA, 22903, USA

    Lauren C. Peres, Sarah E. Abbott, Fabian Camacho & Joellen M. Schildkraut

  2. Department of Community and Family Medicine, Duke University Medical Center, 2424 Erwin Rd., Suite 602, Durham, NC, 27705, USA

    Patricia G. Moorman & Frances Wang

  3. Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, 68 President St., Bioengineering Building 103, Charleston, SC, 29425, USA

    Anthony J. Alberg

  4. Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08903, USA

    Elisa V. Bandera

  5. Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, 2-526 Wolstein Research Building, 2103 Cornell Rd., Cleveland, OH, 44106, USA

    Jill Barnholtz-Sloan

  6. Cancer Prevention and Population Sciences Program, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA

    Melissa Bondy

  7. Department of Oncology and the Karmanos Cancer Institute Population Studies and Disparities Research Program, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA

    Michele L. Cote & Ann G. Schwartz

  8. Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 611, 1717 11th Ave. South, Birmingham, AL, 35205, USA

    Ellen Funkhouser

  9. Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier St. 3rd Floor, New Orleans, LA, 70112, USA

    Edward S. Peters

  10. Department of Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcola Highway Box U-114, Knoxville, TN, 37920, USA

    Paul D. Terry

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  1. Lauren C. Peres
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  2. Patricia G. Moorman
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  11. Paul D. Terry
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  14. Frances Wang
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  15. Joellen M. Schildkraut
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Correspondence to Lauren C. Peres.

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Peres, L.C., Moorman, P.G., Alberg, A.J. et al. Lifetime number of ovulatory cycles and epithelial ovarian cancer risk in African American women. Cancer Causes Control 28, 405–414 (2017). https://doi.org/10.1007/s10552-017-0853-7

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  • DOI: https://doi.org/10.1007/s10552-017-0853-7

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