Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study

被引：28

作者：

Besevic, Jelena ^{[1
]}

Gunter, Marc J. ^{[1
]}

Fortner, Renee T. ^{[2
]}

Tsilidis, Konstantinos K. ^{[1
,3
]}

Weiderpass, Elisabete ^{[4
,5
,6
,7
]}

Onland-Moret, N. Charlotte ^{[8
]}

Dossus, Laure ^{[9
,10
,11
]}

Tjonneland, Anne ^{[12
]}

Hansen, Louise ^{[12
]}

Overvad, Kim ^{[13
]}

Mesrine, Sylvie ^{[9
,10
,11
]}

Baglietto, Laura ^{[14
,15
]}

Clavel-Chapelon, Francoise ^{[9
,10
,11
]}

Kaaks, Rudolf ^{[2
]}

Aleksandrova, Krasimira ^{[16
]}

Boeing, Heiner ^{[16
]}

Trichopoulou, Antonia ^{[17
,18
]}

Lagiou, Pagona ^{[19
,20
]}

Bamia, Christina ^{[20
]}

Masala, Giovanna ^{[21
]}

Agnoli, Claudia ^{[22
]}

Tumino, Rosario ^{[23
]}

Ricceri, Fulvio ^{[24
,25
]}

Panico, Salvatore ^{[26
]}

Bueno-de-Mesquita, H. B. ^{[1
,27
,28
,29
]}

Peeters, Petra H. ^{[1
,8
]}

Jareid, Mie ^{[4
]}

Ramon Quiros, J. ^{[30
]}

Duell, Eric J. ^{[31
]}

Sanchez, Maria-Jose ^{[32
,33
]}

Larranaga, Nerea ^{[33
,34
]}

Chirlaque, Maria-Dolores ^{[33
,35
]}

Barricarte, Aurelio ^{[33
,36
,37
]}

Dias, Joana A. ^{[38
]}

Sonestedt, Emily ^{[38
]}

Idahl, Annika ^{[39
,40
]}

Lundin, Eva ^{[41
]}

Wareham, Nicholas J. ^{[42
]}

Khaw, Kay-Tee ^{[43
]}

Travis, Ruth C.

Rinaldi, Sabina ^{[44
,45
]}

Romieu, Isabelle ^{[44
,45
]}

Riboli, Elio ^{[1
]}

Merritt, Melissa A. ^{[1
]}

机构：

[1] Univ London Imperial Coll Sci Technol & Med, Sch Publ Hlth, Dept Epidemiol & Biostat, London W2 1PG, England

[2] German Canc Res Ctr, Div Canc Epidemiol, D-69120 Heidelberg, Germany

[3] Univ Ioannina, Sch Med, Dept Hyg & Epidemiol, GR-45110 Ioannina, Greece

[4] Univ Tromso, Arctic Univ Norway, Fac Hlth Sci, Dept Community Med, N-9037 Tromso, Norway

[5] Canc Registry Norway, Dept Res, N-0304 Oslo, Norway

[6] Karolinska Inst, Dept Med Epidemiol & Biostat, S-17177 Stockholm, Sweden

[7] Folkhalsan Res Ctr, Genet Epidemiol Grp, FI-00290 Helsinki, Finland

[8] Univ Med Ctr Utrecht, Julius Ctr Hlth Sci & Primary Care, NL-3508 GA Utrecht, Netherlands

[9] Ctr Res Epidemiol & Populat Hlth CESP, INSERM, U1018, Lifestyle Genes & Hlth Integrat Trans Generat Epi, F-94805 Villejuif, France

[10] Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France

[11] Inst Gustave Roussy, F-94805 Villejuif, France

[12] Danish Canc Soc, Res Ctr, DK-2100 Copenhagen, Denmark

[13] Aarhus Univ, Dept Publ Hlth, Sect Epidemiol, DK-8000 Aarhus C, Denmark

[14] Canc Council Victoria, Canc Epidemiol Ctr, Melbourne, Vic 3004, Australia

[15] Univ Melbourne, Sch Populat & Global Hlth, Ctr Epidemiol & Biostat, Melbourne, Vic 3010, Australia

[16] German Inst Human Nutr Potsdam Rehbrucke, Dept Epidemiol, D-14558 Nuthetal, Germany

[17] Hellenic Hlth Fdn, GR-11527 Athens, Greece

[18] Acad Athens, Bureau Epidemiol Res, GR-11527 Athens, Greece

[19] Harvard Univ, Sch Publ Hlth, Dept Epidemiol, Boston, MA 02115 USA

[20] Univ Athens, Sch Med, Dept Hyg Epidemiol & Med Stat, GR-11527 Athens, Greece

[21] Canc Res & Prevent inst ISPO, Mol & Nutr Epidemiol Unit, I-50141 Florence, Italy

[22] Fdn IRCCS Ist Nazl Tumori, Epidemiol & Prevent Unit, I-20133 Milan, Italy

[23] ASP, Civ MP Arezzo Hosp, Canc Registry & Histopathol Unit, I-97100 Ragusa, Italy

[24] Reg Hlth Serv ASL TO3, Unit Epidemiol, I-10095 Grugliasco, TO, Italy

[25] Univ Turin, Dept Med Sci, Unit Canc Epidemiol, I-10126 Turin, Italy

[26] Univ Naples Federico II, Dipartimento Med Clin & Chirurg, I-80131 Naples, Italy

[27] Natl Inst Publ Hlth & Environm RIVM, Dept Determinants Chron Dis DCD, NL-3720 BA Bilthoven, Netherlands

[28] Univ Med Ctr Utrecht, Dept Gastroenterol & Hepatol, NL-3584 CX Utrecht, Netherlands

[29] Univ Malaya, Fac Med, Dept Social & Prevent Med, Kuala Lumpur 50603, Malaysia

[30] Publ Hlth Directorate, Oviedo 33006, Spain

[31] Catalan Inst Oncol ICO IDIBELL, Canc Epidemiol Res Program, Unit Nutr & Canc, Barcelona 08908, Spain

[32] Univ Granada, Cuesta Observ, Hosp Univ Granada, Escuela Andaluza Salud Publ,Inst Investigac Biosa, Granada 18080, Spain

[33] CIBERESP, Madrid 28029, Spain

[34] Reg Govt Basque Country, Publ Hlth Div Gipuzkoa, Donostia San Sebastian, Spain

[35] IMIB Arrixaca, Murcia Reg Hlth Council, Dept Epidemiol, Murcia 30008, Spain

[36] Navarra Publ Hlth Inst, Pamplona 31003, Spain

[37] IdiSNA, Navarra Inst Hlth Res, Pamplona 31008, Spain

[38] Lund Univ, Dept Clin Sci Malmo, S-20502 Malmo, Sweden

[39] Umea Univ, Dept Clin Sci Obstet & Gynecol, SE-90187 Umea, Sweden

[40] Umea Univ, Dept Publ Hlth & Clin Med Nutr Res, SE-90187 Umea, Sweden

[41] Umea Univ, Dept Med Biosci & Pathol, SE-90187 Umea, Sweden

[42] Univ Cambridge, Inst Metab Sci, MRC Epidemiol Unit, Cambridge CB2 0QQ, England

[43] Univ Cambridge, Sch Clin Med, Addenbrookes Hosp, Cambridge CB2 0SP, England

[44] Univ Oxford, Nuffield Dept Populat Hlth, Canc Epidemiol Unit, Oxford OX3 7LF, England

[45] Int Agcy, Res Canc, F-69372 Lyon 08, France

来源：

BRITISH JOURNAL OF CANCER | 2015年 / 113卷 / 11期

基金：

英国医学研究理事会; 瑞典研究理事会;

关键词：

epithelial ovarian cancer; menopausal hormone therapy; survival; oral contraceptives; parity; HORMONAL FACTORS; RISK; THERAPY; IMPACT; BREAST;

D O I：

10.1038/bjc.2015.377

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25-70 years at recruitment from 1992 to 2000. Methods: Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre. Results: After a mean follow-up of 3.6 years (+/- 3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever vs never use, HR = 0.80, 95% CI = 0.62-1.03) and a significant survival benefit in long-term MHT users (>= 5 years use vs never use, HR = 0.70, 95% CI = 0.50-0.99, P-trend = 0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk. Conclusions: Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.

引用

页码：1622 / 1631

页数：10

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