TY - JOUR
T1 - Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study
AU - Be͉ević, Jelena
AU - Gunter, Marc J.
AU - Fortner, Renee T.
AU - Tsilidis, Konstantinos K.
AU - Weiderpass, Elisabete
AU - Onland-Moret, N. Charlotte
AU - Dossus, Laure
AU - TjØnneland, Anne
AU - Hansen, Louise
AU - Overvad, Kim
AU - Mesrine, Sylvie
AU - Baglietto, Laura
AU - Clavel-Chapelon, Francoise
AU - Kaaks, Rudolf
AU - Aleksandrova, Krasimira
AU - Boeing, Heiner
AU - Trichopoulou, Antonia
AU - Lagiou, Pagona
AU - Bamia, Christina
AU - Masala, Giovanna
AU - Agnoli, Claudia
AU - Tumino, Rosario
AU - Ricceri, Fulvio
AU - Panico, Salvatore
AU - Bueno-de-Mesquita, H. B.
AU - Peeters, Petra H.
AU - Jareid, Mie
AU - Quirós, J. Ramon
AU - Duell, Eric J.
AU - Sánchez, Maria Jose
AU - Larrañaga, Nerea
AU - Chirlaque, Maria Dolores
AU - Barricarte, Aurelio
AU - Dias, Joana A.
AU - Sonestedt, Emily
AU - Idahl, Annika
AU - Lundin, Eva
AU - Wareham, Nicholas J.
AU - Khaw, Kay Tee
AU - Travis, Ruth C.
AU - Rinaldi, Sabina
AU - Romieu, Isabelle
AU - Riboli, Elio
AU - Merritt, Melissa A.
PY - 2015/12/1
Y1 - 2015/12/1
N2 - 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.
AB - 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.
KW - epithelial ovarian cancer
KW - menopausal hormone therapy
KW - oral contraceptives
KW - parity
KW - survival
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U2 - 10.1038/bjc.2015.377
DO - 10.1038/bjc.2015.377
M3 - Article
AN - SCOPUS:84949318864
SN - 0007-0920
VL - 113
SP - 1622
EP - 1631
JO - British Journal of Cancer
JF - British Journal of Cancer
IS - 11
ER -