Abstract
Background: Previous studies on the association between reproductive factors and ovarian cancer survival are equivocal, possibly due to small sample sizes. Methods: Using data on 11,175 people diagnosed with primary invasive epithelial ovarian, fallopian tube, or primary peritoneal cancer (ovarian cancer) from 16 studies in the Ovarian Cancer Association Consortium (OCAC), we examined the associations between survival and age at menarche, combined oral contraceptive use, parity, breastfeeding, age at last pregnancy, and menopausal status using Cox proportional hazard models. The models were adjusted for age at diagnosis, race/ethnicity, education level, and OCAC study and stratified on stage and histotype. Results: During the mean follow-up of 6.34 years (SD ¼ 4.80), 6,418 patients passed away (57.4%). There was no evidence of associations between the reproductive factors and survival among patients with ovarian cancer overall or by histotype. Conclusions: This study found no association between reproductive factors and survival after an ovarian cancer diagnosis. Impact: Reproductive factors are well-established risk factors for ovarian cancer, but they are not associated with survival after a diagnosis of ovarian cancer.
| Original language | English |
|---|---|
| Pages (from-to) | 903-913 |
| Number of pages | 11 |
| Journal | Cancer Epidemiology Biomarkers and Prevention |
| Volume | 31 |
| Issue number | 4 |
| DOIs | |
| State | Published - Apr 2022 |
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In: Cancer Epidemiology Biomarkers and Prevention, Vol. 31, No. 4, 04.2022, p. 903-913.
Research output: Contribution to journal › Article › peer-review
TY - JOUR
T1 - Reproductive Factors Do Not Influence Survival with Ovarian Cancer
AU - for the Multidisciplinary Ovarian Cancer Outcomes Group
AU - the Ovarian Cancer Association Consortium
AU - for the Multidisciplinary Ovarian Cancer Outcomes Group
AU - the Ovarian Cancer Association Consortium
AU - for the Australian Ovarian Cancer Study Group
AU - the Multidisciplinary Ovarian Cancer Outcomes Group
AU - the Ovarian Cancer Association Consortium
AU - Phung, Minh Tung
AU - Alimujiang, Aliya
AU - Berchuck, Andrew
AU - Anton-Culver, Hoda
AU - Schildkraut, Joellen M.
AU - Bandera, Elisa V.
AU - Chang-Claude, Jenny
AU - Chase, Anne
AU - Doherty, Jennifer Anne
AU - Grout, Bronwyn
AU - Goodman, Marc T.
AU - Hanley, Gillian E.
AU - Lee, Alice W.
AU - Deurloo, Cindy Mc Kinnon
AU - Menon, Usha
AU - Modugno, Francesmary
AU - Pharoah, Paul D.P.
AU - Pike, Malcolm C.
AU - Richardson, Jean
AU - Risch, Harvey A.
AU - Sieh, Weiva
AU - Terry, Kathryn L.
AU - Webb, Penelope M.
AU - Wentzensen, Nicolas
AU - Wu, Anna H.
AU - Pearce, Celeste Leigh
N1 - Funding Information: We are grateful to the family and friends of Kathryn Sladek Smith for their generous support of the Ovarian Cancer Association Consortium through their donations to the Ovarian Cancer Research Fund. We thank the study participants, doctors, nurses, clinical and scientific collaborators, health care providers, and health information sources who have contributed to the studies contributing to this article. Acknowledgements for individual studies: AUS: The AOCS also acknowledges the cooperation of the participating institutions in Australia, and the contribution of the study nurses, research assistants and all clinical and scientific collaborators. The complete AOCS Study Group can be found at www.aocstudy.org. We would like to thank all of the women who participated in this research program; CON: The cooperation of the 32 Connecticut hospitals, including Stamford Hospital, in allowing patient access, is gratefully acknowledged. This study was approved by the State of Connecticut Department of Public Health Human Investigation Committee. Certain data used in this study were obtained from the Connecticut Tumor Registry in the Connecticut Department of Public Health. The authors assume full responsibility for analyses and interpretation of these data; GER: The German Ovarian Cancer Study thank Ursula Eilber for competent technical assistance; OPL: Members of the OPAL Study Group (http://opalstudy.qimrberghofer.edu.au/); SEA: SEARCH team, Craig Luccarini, Caroline Baynes, Don Conroy; UKO: We particularly thank I. Jacobs, M. Widschwendter, E. Wozniak, A. Ryan, J. Ford and N. Balogun for their contribution to the study. NJO: Drs. S. Olson, L. Paddock, and L. Rodriguez, and research staff at the Rutgers Cancer Institute of New Jersey, Memorial Sloan-Kettering Cancer Center, and the New Jersey State Cancer Registry. OCAC Funding: The Ovarian Funding Information: We are grateful to the family and friends of Kathryn Sladek Smith for their generous support of the Ovarian Cancer Association Consortium through their donations to the Ovarian Cancer Research Fund. We thank the study participants, doctors, nurses, clinical and scientific collaborators, health care providers, and health information sources who have contributed to the studies contributing to this article. Acknowledgements for individual studies: AUS: The AOCS also acknowledges the cooperation of the participating institutions in Australia, and the contribution of the study nurses, research assistants and all clinical and scientific collaborators. The complete AOCS Study Group can be found at www.aocstudy.org. We would like to thank all of the women who participated in this research program; CON: The cooperation of the 32 Connecticut hospitals, including Stamford Hospital, in allowing patient access, is gratefully acknowledged. This study was approved by the State of Connecticut Department of Public Health Human Investigation Committee. Certain data used in this study were obtained from the Connecticut Tumor Registry in the Connecticut Department of Public Health. The authors assume full responsibility for analyses and interpretation of these data; GER: The German Ovarian Cancer Study thank Ursula Eilber for competent technical assistance; OPL: Members of the OPAL Study Group (http://opalstudy.qimrberghofer.edu.au/); SEA: SEARCH team, Craig Luccarini, Caroline Baynes, Don Conroy; UKO: We particularly thank I. Jacobs, M. Widschwendter, E. Wozniak, A. Ryan, J. Ford and N. Balogun for their contribution to the study. NJO: Drs. S. Olson, L. Paddock, and L. Rodriguez, and research staff at the Rutgers Cancer Institute of New Jersey, Memorial Sloan-Kettering Cancer Center, and the New Jersey State Cancer Registry. OCAC Funding: The Ovarian Cancer Association Consortium is supported by a grant from the Ovarian Cancer Research Fund thanks to donations by the family and friends of Kathryn Sladek Smith (PPD/RPCI.07 to A. Berchuck). The scientific development and funding for this project were in part supported by the US National Cancer Institute GAME-ON PostGWAS Initiative (U19-CA148112; to C.L. Pearce and J.M. Schildkraut). Funding for individual studies: AUS: The Australian Ovarian Cancer Study (AOCS) was supported by the U.S. Army Medical Research and Materiel Command (DAMD17-01-1-0729; to P.M. Webb), National Health & Medical Research Council of Australia (199600, 400413 and 400281; to P.M. Webb), Cancer Councils of New South Wales, Victoria, Queensland, South Australia and Tasmania and Cancer Foundation of Western Australia (Multi-State Applications 191, 211, and 182; to P.M. Webb). AOCS gratefully acknowledges additional support from Ovarian Cancer Australia and the Peter MacCallum Foundation; P.M. Webb is supported by NHMRC Investigator Grant APP1173346; OPL: National Health and Medical Research Council (NHMRC) of Australia (APP1025142, APP1120431 to P.M. Webb) and Brisbane Women?s Club (to P.M. Webb); GER: German Federal Ministry of Education and Research, Program of Clinical Biomedical Research (01 GB 9401; to J. Chang-Claude), and the German Cancer Research Center (DKFZ, to J. Chang-Claude); POL: Intramural Research Program of the National Cancer Institute (to N. Wentzensen); SEA: The SEARCH study was supported by Cancer Research UK (C490/A8339, C490/A10119, C490/ A10124, and C490/A16561; to P.D.P. Pharoah) and UK National Institute for Health Research Biomedical Research Center at the University of Cambridge (to P.D.P. Pharoah); UKO: The UKOPS study was funded by The Eve Appeal (The Oak Foundation; to U. Menon) with investigators supported by the National Institute for Health Research University College London Hospitals Biomedical Research Center and (MR_UU_12023; to U. Menon); STA: NIH grants U01 CA71966 and U01 CA69417 (to W. Sieh); CON: National Institutes of Health (R01-CA063678, R01-CA074850; R01-CA080742; to H.A. Risch); DOV: National Institutes of Health R01-CA112523 and R01-CA87538 (to J.A. Doherty); HAW: U.S. National Institutes of Health (R01-CA58598, N01-CN-55424 and N01-PC-67001; to M.T. Goodman); HOP: Department of Defense (DAMD17-02-1-0669; to F. Modugno) and NCI (K07-CA080668, R01-CA95023, P50-CA159981, MO1-RR000056, R01-CA126841; to F. Modugno); NCO: National Institutes of Health (R01-CA76016; to A. Berchuck and J.M. Schildkraut) and the Department of Defense (DAMD17-02-1-0666 to A. Berchuck); NEC: National Institutes of Health R01-CA54419 and P50-CA105009 and Department of Defense W81XWH-10-1-02802 (to K.L. Terry); NJO: National Cancer Institute (NIH-K07 CA095666, R01-CA83918, NIH-K22-CA138563, and P30-CA072720; to E.V. Bandera) and the Rutgers Cancer Institute of New Jersey (to E.V. Bandera); UCI: NIH (R01-CA058860; to H. Anton-Culver) and the Lon V Smith Foundation (grant LVS-39420; to H. Anton-Culver); USC: National Institutes of Health (P01CA17054, N01PC67010, N01CN025403; to A.H. Wu, M.C. Pike, and C.L. Pearce; P30CA14089; to A.H. Wu and M.C. Pike; R01CA61132 to M.C. Pike; R03CA113148 and R03CA115195; to C.L. Pearce); and California Cancer Research Program (00-01389V-20170; to M.C. Pike and C.L. Pearce; 2II0200; to A.H. Wu); Dr. Pike is partially supported by the NIH/NCI support grant P30 CA008748 to Memorial Sloan Kettering Cancer Center. Funding Information: Cancer Association Consortium is supported by a grant from the Ovarian Cancer Research Fund thanks to donations by the family and friends of Kathryn Sladek Smith (PPD/RPCI.07 to A. Berchuck). The scientific development and funding for this project were in part supported by the US National Cancer Institute GAME-ON Post-GWAS Initiative (U19-CA148112; to C.L. Pearce and J.M. Schildkraut). Funding for individual studies: AUS: The Australian Ovarian Cancer Study (AOCS) was supported by the U.S. Army Medical Research and Materiel Command (DAMD17-01-1-0729; to P.M. Webb), National Health & Medical Research Council of Australia (199600, 400413 and 400281; to P.M. Webb), Cancer Councils of New South Wales, Victoria, Queensland, South Australia and Tasmania and Cancer Foundation of Western Australia (Multi-State Applications 191, 211, and 182; to P.M. Webb). AOCS gratefully acknowledges additional support from Ovarian Cancer Australia and the Peter MacCallum Foundation; P.M. Webb is supported by NHMRC Investigator Grant APP1173346; OPL: National Health and Medical Research Council (NHMRC) of Australia (APP1025142, APP1120431 to P.M. Webb) and Brisbane Women’s Club (to P.M. Webb); GER: German Federal Ministry of Education and Research, Program of Clinical Biomedical Research (01 GB 9401; to J. Chang-Claude), and the German Cancer Research Center (DKFZ, to J. Chang-Claude); POL: Intramural Research Program of the National Cancer Institute (to N. Wentzensen); SEA: The SEARCH study was supported by Cancer Research UK (C490/A8339, C490/A10119, C490/ A10124, and C490/A16561; to P.D.P. Pharoah) and UK National Institute for Health Research Biomedical Research Center at the University of Cambridge (to P.D.P. Pharoah); UKO: The UKOPS study was funded by The Eve Appeal (The Oak Foundation; to U. Menon) with investigators supported by the National Institute for Health Research University College London Hospitals Biomedical Research Center and (MR_UU_12023; to U. Menon); STA: NIH grants U01 CA71966 and U01 CA69417 (to W. Sieh); CON: National Institutes of Health (R01-CA063678, Funding Information: J.M. Schildkraut reports grants from NIH/NCI during the conduct of the study. E.V. Bandera reports Serving in a Pfizer Advisory Board to Enhance Diversity in Clinical Trials. U. Menon reports grants from Cancer Research UK (CRUK), The Eve Appeal, grants from NIHR HTA, UCL GCRF Internal Small Grant, MRC Proximity to Discovery Industrial Connectivity Award, grants from NIHR BRC UCLH, other support from Abcodia Ltd., British Council, and personal fees from New York Obs. and Gyne. Society, outside the submitted work; in addition, and reports a patent for Patent no: EP10178345.4 issued. F. Modugno reports grants from National Cancer Institute and Department of Defense during the conduct of the study. P.D.P. Pharoah reports grants from Cancer Research UK during the conduct of the study. H.A. Risch reports grants from NIH during the conduct of the study. P.M. Webb reports grants from U.S. Army Medical Research and Materiel Command and National Health and Medical Research Council of Australia during the conduct of the study; grants from AstraZeneca outside the submitted work. C.L. Pearce reports grants from DoD and NIH during the conduct of the study. No disclosures were reported by the other authors. Publisher Copyright: © 2022 American Association for Cancer Research
PY - 2022/4
Y1 - 2022/4
N2 - Background: Previous studies on the association between reproductive factors and ovarian cancer survival are equivocal, possibly due to small sample sizes. Methods: Using data on 11,175 people diagnosed with primary invasive epithelial ovarian, fallopian tube, or primary peritoneal cancer (ovarian cancer) from 16 studies in the Ovarian Cancer Association Consortium (OCAC), we examined the associations between survival and age at menarche, combined oral contraceptive use, parity, breastfeeding, age at last pregnancy, and menopausal status using Cox proportional hazard models. The models were adjusted for age at diagnosis, race/ethnicity, education level, and OCAC study and stratified on stage and histotype. Results: During the mean follow-up of 6.34 years (SD ¼ 4.80), 6,418 patients passed away (57.4%). There was no evidence of associations between the reproductive factors and survival among patients with ovarian cancer overall or by histotype. Conclusions: This study found no association between reproductive factors and survival after an ovarian cancer diagnosis. Impact: Reproductive factors are well-established risk factors for ovarian cancer, but they are not associated with survival after a diagnosis of ovarian cancer.
AB - Background: Previous studies on the association between reproductive factors and ovarian cancer survival are equivocal, possibly due to small sample sizes. Methods: Using data on 11,175 people diagnosed with primary invasive epithelial ovarian, fallopian tube, or primary peritoneal cancer (ovarian cancer) from 16 studies in the Ovarian Cancer Association Consortium (OCAC), we examined the associations between survival and age at menarche, combined oral contraceptive use, parity, breastfeeding, age at last pregnancy, and menopausal status using Cox proportional hazard models. The models were adjusted for age at diagnosis, race/ethnicity, education level, and OCAC study and stratified on stage and histotype. Results: During the mean follow-up of 6.34 years (SD ¼ 4.80), 6,418 patients passed away (57.4%). There was no evidence of associations between the reproductive factors and survival among patients with ovarian cancer overall or by histotype. Conclusions: This study found no association between reproductive factors and survival after an ovarian cancer diagnosis. Impact: Reproductive factors are well-established risk factors for ovarian cancer, but they are not associated with survival after a diagnosis of ovarian cancer.
UR - http://www.scopus.com/inward/record.url?scp=85129007653&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-21-1091
DO - 10.1158/1055-9965.EPI-21-1091
M3 - Article
C2 - 35064059
AN - SCOPUS:85129007653
SN - 1055-9965
VL - 31
SP - 903
EP - 913
JO - Cancer Epidemiology Biomarkers and Prevention
JF - Cancer Epidemiology Biomarkers and Prevention
IS - 4
ER -