Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study

Emma L.Kaderly Rasmussen; Charlotte Gerd Hannibal; Christian Dehlendorff; Louise Baandrup; Jette Junge; Russell Vang; Robert J. Kurman; Susanne K. Kjaer

doi:10.1016/j.ygyno.2017.01.002

Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study

Emma L.Kaderly Rasmussen, Charlotte Gerd Hannibal, Christian Dehlendorff, Louise Baandrup, Jette Junge, Russell Vang, Robert J. Kurman, Susanne K. Kjaer^*

^*Corresponding author af dette arbejde

Institut for Klinisk Medicin

15 Citationer (Scopus)

Abstract

Objective Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. Methods This nationwide case-control study included all women with an SBT diagnosis in Denmark, 1978–2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results We found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (p < 0.01). Older age at first birth also decreased the SBT risk (p = 0.03). An increased SBT risk was associated with infertility (OR = 3.31; 95% CI: 2.44–4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR = 1.32; 95% CI: 1.02–1.72), whereas OC use decreased the risk (OR = 0.40; 95% CI: 0.26–0.62). Conclusions Our nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors.

Originalsprog	Engelsk
Tidsskrift	Gynecologic Oncology
Vol/bind	144
Udgave nummer	3
Sider (fra-til)	571-576
Antal sider	6
ISSN	0090-8258
DOI	https://doi.org/10.1016/j.ygyno.2017.01.002
Status	Udgivet - mar. 2017

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10.1016/j.ygyno.2017.01.002

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Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study. / Rasmussen, Emma L.Kaderly; Hannibal, Charlotte Gerd; Dehlendorff, Christian et al.
I: Gynecologic Oncology, Bind 144, Nr. 3, 03.2017, s. 571-576.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

@article{20ff7a1f1d55401da750aaaef1aed2d8,

title = "Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study",

abstract = "Objective Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. Methods This nationwide case-control study included all women with an SBT diagnosis in Denmark, 1978–2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results We found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (p < 0.01). Older age at first birth also decreased the SBT risk (p = 0.03). An increased SBT risk was associated with infertility (OR = 3.31; 95% CI: 2.44–4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR = 1.32; 95% CI: 1.02–1.72), whereas OC use decreased the risk (OR = 0.40; 95% CI: 0.26–0.62). Conclusions Our nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors.",

keywords = "Hormone replacement therapy (HRT), Infertility, Oral contraceptive (OC), Ovarian serous borderline tumor (SBT), Parity, Risk factor",

author = "Rasmussen, {Emma L.Kaderly} and Hannibal, {Charlotte Gerd} and Christian Dehlendorff and Louise Baandrup and Jette Junge and Russell Vang and Kurman, {Robert J.} and Kjaer, {Susanne K.}",

year = "2017",

month = mar,

doi = "10.1016/j.ygyno.2017.01.002",

language = "English",

volume = "144",

pages = "571--576",

journal = "Gynecologic Oncology",

issn = "0090-8258",

publisher = "Academic Press",

number = "3",

}

TY - JOUR

T1 - Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors

T2 - A nationwide case-control study

AU - Rasmussen, Emma L.Kaderly

AU - Hannibal, Charlotte Gerd

AU - Dehlendorff, Christian

AU - Baandrup, Louise

AU - Junge, Jette

AU - Vang, Russell

AU - Kurman, Robert J.

AU - Kjaer, Susanne K.

PY - 2017/3

Y1 - 2017/3

N2 - Objective Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. Methods This nationwide case-control study included all women with an SBT diagnosis in Denmark, 1978–2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results We found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (p < 0.01). Older age at first birth also decreased the SBT risk (p = 0.03). An increased SBT risk was associated with infertility (OR = 3.31; 95% CI: 2.44–4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR = 1.32; 95% CI: 1.02–1.72), whereas OC use decreased the risk (OR = 0.40; 95% CI: 0.26–0.62). Conclusions Our nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors.

AB - Objective Few studies have examined the risk of an ovarian serous borderline tumor (SBT) associated with parity, infertility, oral contraceptives (OCs), or hormone replacement therapy (HRT), which was the study aim. Methods This nationwide case-control study included all women with an SBT diagnosis in Denmark, 1978–2002. SBTs were confirmed by centralized expert pathology review. For each case, 15 age-matched female controls were randomly selected using risk-set sampling. Cases and controls with previous cancer (except for non-melanoma skin cancer) and controls with bilateral oophorectomy or salpingo-oophorectomy were excluded. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results We found a strongly decreased risk of SBTs among parous women which decreased with increasing number of children (p < 0.01). Older age at first birth also decreased the SBT risk (p = 0.03). An increased SBT risk was associated with infertility (OR = 3.31; 95% CI: 2.44–4.49), which was present both among parous and nulliparous women. HRT use increased the SBT risk (OR = 1.32; 95% CI: 1.02–1.72), whereas OC use decreased the risk (OR = 0.40; 95% CI: 0.26–0.62). Conclusions Our nationwide study with expert histopathologic review of all SBTs showed that parity, infertility, use of HRT, and use of OCs, respectively, were strongly associated with the risk of SBTs. This is the first study to report a strong and significantly decreased SBT risk associated with OC use and a significantly increased risk with infertility, and HRT use. This supports that SBTs and serous ovarian cancer share similar risk factors.

KW - Hormone replacement therapy (HRT)

KW - Infertility

KW - Oral contraceptive (OC)

KW - Ovarian serous borderline tumor (SBT)

KW - Parity

KW - Risk factor

U2 - 10.1016/j.ygyno.2017.01.002

DO - 10.1016/j.ygyno.2017.01.002

M3 - Journal article

C2 - 28108026

AN - SCOPUS:85009794045

SN - 0090-8258

VL - 144

SP - 571

EP - 576

JO - Gynecologic Oncology

JF - Gynecologic Oncology

IS - 3

ER -

Parity, infertility, oral contraceptives, and hormone replacement therapy and the risk of ovarian serous borderline tumors: A nationwide case-control study

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