Association between endometriosis and risk of histological subtypes of ovarian cancer: A pooled analysis of case-control studies

Celeste Leigh Pearce, Claire Templeman, Mary Anne Rossing, Alice Lee, Aimee M. Near, Penelope M. Webb, Christina M. Nagle, Jennifer A. Doherty, Kara L. Cushing-Haugen, Kristine G. Wicklund, Jenny Chang-Claude, Rebecca Hein, Galina Lurie, Lynne R. Wilkens, Michael E. Carney, Marc T. Goodman, Kirsten Moysich, Susanne K. Kjaer, Estrid Hogdall, Allan JensenEllen L Goode, Brooke L. Fridley, Melissa C. Larson, Joellen M. Schildkraut, Rachel T. Palmieri, Daniel W. Cramer, Kathryn L. Terry, Allison F. Vitonis, Linda J. Titus, Argyrios Ziogas, Wendy Brewster, Hoda Anton-Culver, Alexandra Gentry-Maharaj, Susan J. Ramus, A. Rebecca Anderson, Doerthe Brueggmann, Peter A. Fasching, Simon A. Gayther, David G. Huntsman, Usha Menon, Roberta B. Ness, Malcolm C. Pike, Harvey Risch, Anna H. Wu, Andrew Berchuck

Research output: Contribution to journalArticle

454 Citations (Scopus)

Abstract

Background: Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Methods: Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. Findings: 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases . vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43-3·84, p<0·0001), low-grade serous (31 [9·2%] of 336 cases, 2·11, 1·39-3·20, p<0·0001), and endometrioid invasive ovarian cancers (169 [13·9%] of 1220 cases, 2·04, 1·67-2·48, p<0·0001). No association was noted between endometriosis and risk of mucinous (31 [6·0%] of 516 cases, 1·02, 0·69-1·50, p=0·93) or high-grade serous invasive ovarian cancer (261 [7·1%] of 3659 cases, 1·13, 0·97-1·32, p=0·13), or borderline tumours of either subtype (serous 103 [9·0%] of 1140 cases, 1·20, 0·95-1·52, p=0·12, and mucinous 65 [8·5%] of 767 cases, 1·12, 0·84-1·48, p=0·45). Interpretation: Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer. Funding: Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation.

Original languageEnglish (US)
Pages (from-to)385-394
Number of pages10
JournalThe Lancet Oncology
Volume13
Issue number4
DOIs
StatePublished - Apr 2012

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Endometriosis
Ovarian Neoplasms
Case-Control Studies
Neoplasms
Biomedical Research
Research
National Institutes of Health (U.S.)
Tasmania
Western Australia
European Union
Oral Contraceptives
Parity
Health Services
Germany
Logistic Models
Odds Ratio
Regression Analysis
Education

ASJC Scopus subject areas

  • Oncology

Cite this

Association between endometriosis and risk of histological subtypes of ovarian cancer : A pooled analysis of case-control studies. / Pearce, Celeste Leigh; Templeman, Claire; Rossing, Mary Anne; Lee, Alice; Near, Aimee M.; Webb, Penelope M.; Nagle, Christina M.; Doherty, Jennifer A.; Cushing-Haugen, Kara L.; Wicklund, Kristine G.; Chang-Claude, Jenny; Hein, Rebecca; Lurie, Galina; Wilkens, Lynne R.; Carney, Michael E.; Goodman, Marc T.; Moysich, Kirsten; Kjaer, Susanne K.; Hogdall, Estrid; Jensen, Allan; Goode, Ellen L; Fridley, Brooke L.; Larson, Melissa C.; Schildkraut, Joellen M.; Palmieri, Rachel T.; Cramer, Daniel W.; Terry, Kathryn L.; Vitonis, Allison F.; Titus, Linda J.; Ziogas, Argyrios; Brewster, Wendy; Anton-Culver, Hoda; Gentry-Maharaj, Alexandra; Ramus, Susan J.; Anderson, A. Rebecca; Brueggmann, Doerthe; Fasching, Peter A.; Gayther, Simon A.; Huntsman, David G.; Menon, Usha; Ness, Roberta B.; Pike, Malcolm C.; Risch, Harvey; Wu, Anna H.; Berchuck, Andrew.

In: The Lancet Oncology, Vol. 13, No. 4, 04.2012, p. 385-394.

Research output: Contribution to journalArticle

Pearce, CL, Templeman, C, Rossing, MA, Lee, A, Near, AM, Webb, PM, Nagle, CM, Doherty, JA, Cushing-Haugen, KL, Wicklund, KG, Chang-Claude, J, Hein, R, Lurie, G, Wilkens, LR, Carney, ME, Goodman, MT, Moysich, K, Kjaer, SK, Hogdall, E, Jensen, A, Goode, EL, Fridley, BL, Larson, MC, Schildkraut, JM, Palmieri, RT, Cramer, DW, Terry, KL, Vitonis, AF, Titus, LJ, Ziogas, A, Brewster, W, Anton-Culver, H, Gentry-Maharaj, A, Ramus, SJ, Anderson, AR, Brueggmann, D, Fasching, PA, Gayther, SA, Huntsman, DG, Menon, U, Ness, RB, Pike, MC, Risch, H, Wu, AH & Berchuck, A 2012, 'Association between endometriosis and risk of histological subtypes of ovarian cancer: A pooled analysis of case-control studies', The Lancet Oncology, vol. 13, no. 4, pp. 385-394. https://doi.org/10.1016/S1470-2045(11)70404-1
Pearce, Celeste Leigh ; Templeman, Claire ; Rossing, Mary Anne ; Lee, Alice ; Near, Aimee M. ; Webb, Penelope M. ; Nagle, Christina M. ; Doherty, Jennifer A. ; Cushing-Haugen, Kara L. ; Wicklund, Kristine G. ; Chang-Claude, Jenny ; Hein, Rebecca ; Lurie, Galina ; Wilkens, Lynne R. ; Carney, Michael E. ; Goodman, Marc T. ; Moysich, Kirsten ; Kjaer, Susanne K. ; Hogdall, Estrid ; Jensen, Allan ; Goode, Ellen L ; Fridley, Brooke L. ; Larson, Melissa C. ; Schildkraut, Joellen M. ; Palmieri, Rachel T. ; Cramer, Daniel W. ; Terry, Kathryn L. ; Vitonis, Allison F. ; Titus, Linda J. ; Ziogas, Argyrios ; Brewster, Wendy ; Anton-Culver, Hoda ; Gentry-Maharaj, Alexandra ; Ramus, Susan J. ; Anderson, A. Rebecca ; Brueggmann, Doerthe ; Fasching, Peter A. ; Gayther, Simon A. ; Huntsman, David G. ; Menon, Usha ; Ness, Roberta B. ; Pike, Malcolm C. ; Risch, Harvey ; Wu, Anna H. ; Berchuck, Andrew. / Association between endometriosis and risk of histological subtypes of ovarian cancer : A pooled analysis of case-control studies. In: The Lancet Oncology. 2012 ; Vol. 13, No. 4. pp. 385-394.
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abstract = "Background: Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Methods: Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. Findings: 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2{\%}] of 674 cases . vs 818 [6·2{\%}] of 13 226 controls, odds ratio 3·05, 95{\%} CI 2·43-3·84, p<0·0001), low-grade serous (31 [9·2{\%}] of 336 cases, 2·11, 1·39-3·20, p<0·0001), and endometrioid invasive ovarian cancers (169 [13·9{\%}] of 1220 cases, 2·04, 1·67-2·48, p<0·0001). No association was noted between endometriosis and risk of mucinous (31 [6·0{\%}] of 516 cases, 1·02, 0·69-1·50, p=0·93) or high-grade serous invasive ovarian cancer (261 [7·1{\%}] of 3659 cases, 1·13, 0·97-1·32, p=0·13), or borderline tumours of either subtype (serous 103 [9·0{\%}] of 1140 cases, 1·20, 0·95-1·52, p=0·12, and mucinous 65 [8·5{\%}] of 767 cases, 1·12, 0·84-1·48, p=0·45). Interpretation: Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer. Funding: Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation.",
author = "Pearce, {Celeste Leigh} and Claire Templeman and Rossing, {Mary Anne} and Alice Lee and Near, {Aimee M.} and Webb, {Penelope M.} and Nagle, {Christina M.} and Doherty, {Jennifer A.} and Cushing-Haugen, {Kara L.} and Wicklund, {Kristine G.} and Jenny Chang-Claude and Rebecca Hein and Galina Lurie and Wilkens, {Lynne R.} and Carney, {Michael E.} and Goodman, {Marc T.} and Kirsten Moysich and Kjaer, {Susanne K.} and Estrid Hogdall and Allan Jensen and Goode, {Ellen L} and Fridley, {Brooke L.} and Larson, {Melissa C.} and Schildkraut, {Joellen M.} and Palmieri, {Rachel T.} and Cramer, {Daniel W.} and Terry, {Kathryn L.} and Vitonis, {Allison F.} and Titus, {Linda J.} and Argyrios Ziogas and Wendy Brewster and Hoda Anton-Culver and Alexandra Gentry-Maharaj and Ramus, {Susan J.} and Anderson, {A. Rebecca} and Doerthe Brueggmann and Fasching, {Peter A.} and Gayther, {Simon A.} and Huntsman, {David G.} and Usha Menon and Ness, {Roberta B.} and Pike, {Malcolm C.} and Harvey Risch and Wu, {Anna H.} and Andrew Berchuck",
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month = "4",
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language = "English (US)",
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issn = "1470-2045",
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TY - JOUR

T1 - Association between endometriosis and risk of histological subtypes of ovarian cancer

T2 - A pooled analysis of case-control studies

AU - Pearce, Celeste Leigh

AU - Templeman, Claire

AU - Rossing, Mary Anne

AU - Lee, Alice

AU - Near, Aimee M.

AU - Webb, Penelope M.

AU - Nagle, Christina M.

AU - Doherty, Jennifer A.

AU - Cushing-Haugen, Kara L.

AU - Wicklund, Kristine G.

AU - Chang-Claude, Jenny

AU - Hein, Rebecca

AU - Lurie, Galina

AU - Wilkens, Lynne R.

AU - Carney, Michael E.

AU - Goodman, Marc T.

AU - Moysich, Kirsten

AU - Kjaer, Susanne K.

AU - Hogdall, Estrid

AU - Jensen, Allan

AU - Goode, Ellen L

AU - Fridley, Brooke L.

AU - Larson, Melissa C.

AU - Schildkraut, Joellen M.

AU - Palmieri, Rachel T.

AU - Cramer, Daniel W.

AU - Terry, Kathryn L.

AU - Vitonis, Allison F.

AU - Titus, Linda J.

AU - Ziogas, Argyrios

AU - Brewster, Wendy

AU - Anton-Culver, Hoda

AU - Gentry-Maharaj, Alexandra

AU - Ramus, Susan J.

AU - Anderson, A. Rebecca

AU - Brueggmann, Doerthe

AU - Fasching, Peter A.

AU - Gayther, Simon A.

AU - Huntsman, David G.

AU - Menon, Usha

AU - Ness, Roberta B.

AU - Pike, Malcolm C.

AU - Risch, Harvey

AU - Wu, Anna H.

AU - Berchuck, Andrew

PY - 2012/4

Y1 - 2012/4

N2 - Background: Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Methods: Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. Findings: 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases . vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43-3·84, p<0·0001), low-grade serous (31 [9·2%] of 336 cases, 2·11, 1·39-3·20, p<0·0001), and endometrioid invasive ovarian cancers (169 [13·9%] of 1220 cases, 2·04, 1·67-2·48, p<0·0001). No association was noted between endometriosis and risk of mucinous (31 [6·0%] of 516 cases, 1·02, 0·69-1·50, p=0·93) or high-grade serous invasive ovarian cancer (261 [7·1%] of 3659 cases, 1·13, 0·97-1·32, p=0·13), or borderline tumours of either subtype (serous 103 [9·0%] of 1140 cases, 1·20, 0·95-1·52, p=0·12, and mucinous 65 [8·5%] of 767 cases, 1·12, 0·84-1·48, p=0·45). Interpretation: Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer. Funding: Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation.

AB - Background: Endometriosis is a risk factor for epithelial ovarian cancer; however, whether this risk extends to all invasive histological subtypes or borderline tumours is not clear. We undertook an international collaborative study to assess the association between endometriosis and histological subtypes of ovarian cancer. Methods: Data from 13 ovarian cancer case-control studies, which were part of the Ovarian Cancer Association Consortium, were pooled and logistic regression analyses were undertaken to assess the association between self-reported endometriosis and risk of ovarian cancer. Analyses of invasive cases were done with respect to histological subtypes, grade, and stage, and analyses of borderline tumours by histological subtype. Age, ethnic origin, study site, parity, and duration of oral contraceptive use were included in all analytical models. Findings: 13 226 controls and 7911 women with invasive ovarian cancer were included in this analysis. 818 and 738, respectively, reported a history of endometriosis. 1907 women with borderline ovarian cancer were also included in the analysis, and 168 of these reported a history of endometriosis. Self-reported endometriosis was associated with a significantly increased risk of clear-cell (136 [20·2%] of 674 cases . vs 818 [6·2%] of 13 226 controls, odds ratio 3·05, 95% CI 2·43-3·84, p<0·0001), low-grade serous (31 [9·2%] of 336 cases, 2·11, 1·39-3·20, p<0·0001), and endometrioid invasive ovarian cancers (169 [13·9%] of 1220 cases, 2·04, 1·67-2·48, p<0·0001). No association was noted between endometriosis and risk of mucinous (31 [6·0%] of 516 cases, 1·02, 0·69-1·50, p=0·93) or high-grade serous invasive ovarian cancer (261 [7·1%] of 3659 cases, 1·13, 0·97-1·32, p=0·13), or borderline tumours of either subtype (serous 103 [9·0%] of 1140 cases, 1·20, 0·95-1·52, p=0·12, and mucinous 65 [8·5%] of 767 cases, 1·12, 0·84-1·48, p=0·45). Interpretation: Clinicians should be aware of the increased risk of specific subtypes of ovarian cancer in women with endometriosis. Future efforts should focus on understanding the mechanisms that might lead to malignant transformation of endometriosis so as to help identify subsets of women at increased risk of ovarian cancer. Funding: Ovarian Cancer Research Fund, National Institutes of Health, California Cancer Research Program, California Department of Health Services, Lon V Smith Foundation, European Community's Seventh Framework Programme, German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research, German Cancer Research Centre, Eve Appeal, Oak Foundation, UK National Institute of Health Research, National Health and Medical Research Council of Australia, US Army Medical Research and Materiel Command, Cancer Council Tasmania, Cancer Foundation of Western Australia, Mermaid 1, Danish Cancer Society, and Roswell Park Alliance Foundation.

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