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

ABSTRACT: 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.

SUBMITTER: Besevic J

PROVIDER: S-EPMC4705888 | biostudies-literature | 2015 Dec

REPOSITORIES: biostudies-literature

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

Bešević Jelena J Gunter Marc J MJ Fortner Renée T RT Tsilidis Konstantinos K KK Weiderpass Elisabete E Onland-Moret N Charlotte NC Dossus Laure L Tjønneland Anne A Hansen Louise L Overvad Kim K Mesrine Sylvie S Baglietto Laura L Clavel-Chapelon Françoise F Kaaks Rudolf R Aleksandrova Krasimira K Boeing Heiner H Trichopoulou Antonia A Lagiou Pagona P Bamia Christina C Masala Giovanna G Agnoli Claudia C Tumino Rosario R Ricceri Fulvio F Panico Salvatore S Bueno-de-Mesquita H Bas HB Peeters Petra H PH Jareid Mie M Quirós J Ramón JR Duell Eric J EJ Sánchez María-José MJ Larrañaga Nerea N Chirlaque María-Dolores MD Barricarte Aurelio A Dias Joana A JA Sonestedt Emily E Idahl Annika A Lundin Eva E Wareham Nicholas J NJ Khaw Kay-Tee KT Travis Ruth C RC Rinaldi Sabina S Romieu Isabelle I Riboli Elio E Merritt Melissa A MA

British journal of cancer 20151110 11

<h4>Background</h4>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.<h4> ...[more]

PMID: 26554655

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Project description:OBJECTIVE:Previous studies suggest that breastfeeding reduces epithelial ovarian cancer (EOC) risk. However, the effects of age, timing and episode details on the EOC-breastfeeding relationship have not been examined. The objective of this study was to examine the association between breastfeeding factors and epithelial ovarian cancer. METHODS:We examined breastfeeding factors among parous women in a population-based, case-control study conducted in Pennsylvania, Ohio, and New York from 2003 to 2008. We compared 689 incident EOC cases to 1572 community controls. Multivariable unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) associated with breastfeeding patterns adjusting for potential confounders. RESULTS:Compared to never breastfeeding, breastfeeding any offspring was associated with a 30% reduction in EOC risk (OR = 0.70; 95%CI = 0.58-0.85). That association lasted more than 30 years (OR = 0.69, 95%CI = 0.53-0.88). An average breastfeeding episode of 3 months was also associated with reduced risk (OR = 0.73, 95%CI = 0.58-0.80). A greater number of breastfeeding episodes was associated with greater risk reduction (OR = 0.78, 95%CI = 0.64-0.96 and OR = 0.49, 95%CI = 0.36-0.68 1-2 and 3+ episodes, respectively, compared to never breastfed, trend p = 0.01). Longer breastfeeding duration was also associated with reduced risk (OR = 0.75 and 0.62 for less than and greater than 1-year total duration, respectively, compared to never breastfed). An earlier age at first breastfeeding was further associated with increased protection (OR = 0.50-0.80, for first episode at age <25, 25-29, and 30+, respectively, trend p = 0.001). CONCLUSIONS:Breastfeeding for as few as 3 months is associated with reduced EOC risk. Although this association decreases over time, it persists for more than 30 years. Longer cumulative duration, increasing number of breastfeeding episodes, and earlier age at first breastfeeding episode are each associated with increased benefit.

Dataset Information

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

Publications

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

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