TY - JOUR
T1 - Tubal ligation and risk of ovarian cancer subtypes
T2 - A pooled analysis of case-control studies
AU - Sieh, Weiva
AU - Salvador, Shannon
AU - McGuire, Valerie
AU - Weber, Rachel Palmieri
AU - Terry, Kathryn L.
AU - Rossing, Mary Anne
AU - Risch, Harvey
AU - Wu, Anna H.
AU - Webb, Penelope M.
AU - Moysich, Kirsten
AU - Doherty, Jennifer A.
AU - Felberg, Anna
AU - Miller, Dianne
AU - Jordan, Susan J.
AU - Goodman, Marc T.
AU - Lurie, Galina
AU - Chang-Claude, Jenny
AU - Rudolph, Anja
AU - Kjær ̈ger, Susanne Kru
AU - Jensen, Allan
AU - Høgdall, Estrid
AU - Bandera, Elisa V.
AU - Olson, Sara H.
AU - King, Melony G.
AU - Rodriguez-Rodriguez, Lorna
AU - Kiemeney, Lambertus A.
AU - Marees, Tamara
AU - Massuger, Leon F.
AU - van Altena, Anne M.
AU - Ness, Roberta B.
AU - Cramer, Daniel W.
AU - Pike, Malcolm C.
AU - Pearce, Celeste Leigh
AU - Berchuck, Andrew
AU - Schildkraut, Joellen M.
AU - Whittemore, Alice S.
N1 - Funding Information:
This work was supported by donations from the family and friends of Kathryn Sladek Smith to the Ovarian Cancer Research Fund. It was also supported by the U.S. National Institutes of Health: R01CA074850, R01CA080742 (CON), R01CA112523, R01CA87538 (DOV), R01CA58598, N01CN55424, N01PC67001 (HAW), R01CA95023 (HOP), R01CA61107 (MAL), R01CA76016 (NCO), R01CA54419, P50CA105009 (NEC), K07CA095666, R01CA83918, K22CA138563, R01CA120429 (NJO), U01CA71966, U01CA69417, R01CA16056, K07CA143047 (STA), R01CA136891, R01CA14089, R01CA17054, R01CA61132, R01CA 63464, N01PC67010, R03CA113148 (USC); the U.S. Department of Defense: DAMD17-01-1-0729, W81X WH0610220 (AUS), DAMD17-02-1-0669 (HOP), DAMD17-02-1-0666 (NCO), W81XWH-10-1-02802 (NEC); the California Cancer Research Program 00-01389V-20170, 2II0200 (USC); National Health and Medical Research Council of Australia 199600 (AUS); Cancer Councils of New South Wales, Victoria, Queensland, South Australia and Tasmania (AUS); Cancer Foundation of Western Australia (AUS); German Federal Ministry of Education and Research, Programme of Clinical Biomedical Research 01 GB 9401 (GER); German Cancer Research Center (GER); Danish Cancer Society research grant 94 222 52 (MAL); the Mermaid I project (MAL); the Cancer Institute of New Jersey (NJO); Radboud University Nijmegen Medical Centre (NTH); National Health Research and Development Program of Health and Welfare Canada Grant 6613-1415-53 (SON).
PY - 2013/4
Y1 - 2013/4
N2 - Background: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. Methods: We pooled primary data from 13 population-based case-control studies, including 10 157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13 904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. Results: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P<0.001),endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P<0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P<0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P1/4 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P<0.0001) and clear cell (P1/4 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. Conclusions: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.
AB - Background: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. Methods: We pooled primary data from 13 population-based case-control studies, including 10 157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13 904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. Results: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P<0.001),endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P<0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P<0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P1/4 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P<0.0001) and clear cell (P1/4 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. Conclusions: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.
KW - Ovarian cancer
KW - Tubal ligation
KW - Tubal sterilization
UR - http://www.scopus.com/inward/record.url?scp=84877085941&partnerID=8YFLogxK
U2 - 10.1093/ije/dyt042
DO - 10.1093/ije/dyt042
M3 - Article
AN - SCOPUS:84877085941
SN - 0300-5771
VL - 42
SP - 579
EP - 589
JO - International Journal of Epidemiology
JF - International Journal of Epidemiology
IS - 2
ER -