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Annals of Oncology 12:337-341, 2001
© 2001 European Society for Medical Oncology

research-article

Reproductive and hormonal factors and ovarian cancer

F. Chiaffarino1, C. Pelucchi1, F. Parazzini1,2, E. Negri1, S. Franceschi3, R. Talamini4, E. Conti5, M. Montella6 and C. La Vecchia1,7,

1Istituto di Ricerche Farmacologiche Mario Negri
2Prima Clinica Ostetrico Ginecologica, Universita degli Studi di Milano Milan, Italy
3Field and Intervention Studies Unit, International Agency for Research on Cancer Lyon, France
4Servizio di Epidemiologia, Centro di Riferimento Oncologico Aviano (PN)
5Istituto Regina Elena per Io Studio e la Cura dei Tumori Rome
6Istituto per Io Studio e la Cura dei Tumori ‘Senatore Pascale’ Naples
7Istituto di Statistica Medica e Biometria, Universita degli Studi di Milano Milan, Italy

Correspondence to: Dr C. La Vecchia, Istituto di Richerche Farmacologiche ‘Mario Negri’, Via Eritrea 62, 20157 Milan, Italy, E-mail: mnegri{at}irfmn.mnegri.it

Background: Menstrual, reproductive and hormonal factors have been related to ovarian cancer risk, but further quantification of their role in various populations is required.

Patients and methods: Cases were 1031 women, below age 79, with incident, histologically confirmed epithelial ovarian cancer, and controls 2411 women, admitted between 1992 and 1999 to a network of hospitals in 4 Italian areas for acute, nonneoplastic, diseases. Odds ratios (OR) were obtained using multiple logistic regression.

Results: Multiparity was associated with a significant reduction in risk of ovarian cancer (OR = 0.6 for 3, and 0.5 for >4 births). No consistent association was observed with time since first or last birth, nor with spontaneous or induced abortions. Late age at menarche (OR = 0.8), and early menopause (OR = 0.6) were inversely related to risk, as did long-term oral contraceptive use (OR = 0.5, for >5 years). Hormone replacement therapy in menopause was associated with a non-significantly elevated risk (OR = 1.4). The pattern of risk was similar for women with and for those without family history of breast or ovarian cancer.

Conclusions: This uniquely large study confirms and further quantifies the relation between hormonal and reproductive factors and ovarian cancer. The pattern of risk observed cannot be totally explained by a role of ovulation in ovarian carcinogenesis.

epidemiology, female hormones, ovarian cancer, reproduction, risk factors


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