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
N1 - Funding Information:
This work was supported with donations by the family and friends of Kathryn Sladek Smith to the Ovarian Cancer Research Fund. It was also supported by the National Institutes of Health ( R01 CA136891, CA14089, CA17054, CA61132, N01 PC67010, and R03 CA113148 [USC], R01 CA112523, and R01 CA87538 [DOV], R01 CA58598, N01 CN67001, and N01 PC35137 [HAW], 5R01 CA074850 [CON], R01 CA76016 [NCO], CA58860, CA92044, and PSA 042205 [UCI], R01 CA54419 and P50 CA105009 [NEC], R01 CA61107 [MAL], R01 CA95023 and R01 CA126841 [HOP], and R01 CA122443 and P50 CA136393 [MAY]) ; California Cancer Research Program (0001389V20170 and 2110200 [USC]) ; California Department of Health Services (subcontract 050E8709 [USC] ); Lon V Smith Foundation (LVS 39420 [UCI]) ; European Community's Seventh Framework Programme (HEALTH-F2-2009-223175 [GER]) ; German Federal Ministry of Education and Research of Germany, Programme of Clinical Biomedical Research (01GB9401 [GER]) ; German Cancer Research Centre (GER); Eve Appeal (UKO); Oak Foundation (UKO); Women's Health Theme of the UK National Institute of Health Research supported University College London Hospital/University College London Comprehensive Biomedical Research Centre (UKO); National Health and Medical Research Council of Australia (199600 [AUS]) ; US Army Medical Research and Materiel Command (DAMD 170110729 and W81XWH0610220 [AUS], W81XWH1010280 [NEC], and DAMD17-02-1-0669 [HOP]) ; Cancer Council Tasmania (AUS); Cancer Foundation of Western Australia (AUS); Mermaid 1 (MAL); Danish Cancer Society (MAL); and Roswell Park Alliance Foundation (HOP). We thank Ursula Eilber of the German Cancer Research Centre for technical assistance with the German Ovarian Cancer Study (GER). The Australian group gratefully acknowledges the members of the Australian Ovarian Cancer Study Group. Some of the data used in the CON study were obtained from the Connecticut Tumor Registry, Connecticut Department of Public Health. We assume full responsibility for the analyses and interpretation of these data.
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.
UR - http://www.scopus.com/inward/record.url?scp=84859162183&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84859162183&partnerID=8YFLogxK
U2 - 10.1016/S1470-2045(11)70404-1
DO - 10.1016/S1470-2045(11)70404-1
M3 - Article
C2 - 22361336
AN - SCOPUS:84859162183
SN - 1470-2045
VL - 13
SP - 385
EP - 394
JO - The Lancet Oncology
JF - The Lancet Oncology
IS - 4
ER -