Skip to main content
NCBI home page
British Journal of Cancer logoLink to British Journal of Cancer
. 2001 Mar;84(5):714–721. doi: 10.1054/bjoc.2000.1596

Menstrual and reproductive factors in relation to ovarian cancer risk

L Titus-Ernstoff 1, K Perez 1, D W Cramer 2, "V体育2025版" B L Harlow 2, V体育ios版 - J A Baron 1,3, E R Greenberg 1,3
PMCID: PMC2363792  PMID: 11237375

V体育安卓版 - Abstract

We assessed menstrual and reproductive factors in relation to ovarian cancer risk in a large, population-based, case–control study. 563 cases in Massachusetts and New Hampshire were ascertained from hospitals and statewide tumour registries; control women (n= 523) were selected through random digit dialing and matched to case women by age and telephone sampling unit. We used multivariate logistic regression to evaluate factors in relation to risk of ovarian cancer and the major tumour histologic subtypes. Ovarian cancer risk was reduced among parous women, relative to nulliparous women (OR = 0. 4; 95% CI = 0. 3−0. 6). Among parous women, higher parity (P= 0. 0006), increased age at first (P= 0. 03) or last (P= 0. 05) birth, and time since last birth (P= 0. 04) were associated with reduced risk. Early pregnancy losses, abortions, and stillbirths were unrelated to risk, but preterm, term, and twin births were protective. Risk was lower among women who had breast-fed, relative to those who had not (OR = 0. 7; 95% CI = 0. 5–1. 0), but the average duration of breast-feeding per child was unrelated to risk (P for trend = 0. 21). Age at menarche and age at menopause were unrelated to risk overall, although increasing menarcheal age was protective among premenopausal women (P= 0. 02). Menstrual cycle characteristics and symptoms were generally unrelated to risk, although cycle-related insomnia was associated with decreased risk (OR = 0. 5; 95% CI = 0. 3–0 V体育平台登录. 8). We found no association between the type of sanitary product used during menstruation and ovarian cancer risk. In analyses by histologic subtype, reproductive and menstrual factors had most effect on risk of endometrioid/clear cell tumours, and least influential with regard to risk of mucinous tumours. Overall, our findings offer some support to current hypotheses of ovarian pathogenesis, and show aetiologic differences among the tumour subtypes. © 2001 Cancer Research Campaign http://www. bjcancer. com.

Keywords: menstrual cycles, reproductive factors, ovarian cancer

Full Text

The Full Text of this article is available as a PDF (76. 9 KB) V体育官网入口.

Selected References

These references are in PubMed VSports在线直播. This may not be the complete list of references from this article.

  1. Adami H. O., Hsieh C. C., Lambe M., Trichopoulos D., Leon D., Persson I., Ekbom A., Janson P. O. Parity, age at first childbirth, and risk of ovarian cancer. Lancet. 1994 Nov 5;344(8932):1250–1254. doi: 10.1016/s0140-6736(94)90749-8. [DOI] [PubMed] [Google Scholar]
  2. Bean J. A., Leeper J. D., Wallace R. B., Sherman B. M., Jagger H. Variations in the reporting of menstrual histories. Am J Epidemiol. 1979 Feb;109(2):181–185. doi: 10.1093/oxfordjournals.aje.a112673. ["VSports app下载" DOI] [PubMed] [Google Scholar]
  3. Booth M., Beral V., Smith P. Risk factors for ovarian cancer: a case-control study. Br J Cancer. 1989 Oct;60(4):592–598. doi: 10.1038/bjc.1989.320. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Breslow N. E., Day N. E. Statistical methods in cancer research. Volume I - The analysis of case-control studies. IARC Sci Publ. 1980;(32):5–338. [V体育ios版 - PubMed] [Google Scholar]
  5. Casagrande J. T., Louie E. W., Pike M. C., Roy S., Ross R. K., Henderson B. E. "Incessant ovulation" and ovarian cancer. Lancet. 1979 Jul 28;2(8135):170–173. doi: 10.1016/s0140-6736(79)91435-1. ["VSports手机版" DOI] [PubMed] [Google Scholar]
  6. Chen Y., Wu P. C., Lang J. H., Ge W. J., Hartge P., Brinton L. A. Risk factors for epithelial ovarian cancer in Beijing, China. Int J Epidemiol. 1992 Feb;21(1):23–29. doi: 10.1093/ije/21.1.23. [DOI (V体育安卓版)] [PubMed] [Google Scholar]
  7. Cramer D. W., Hutchison G. B., Welch W. R., Scully R. E., Ryan K. J. Determinants of ovarian cancer risk. I. Reproductive experiences and family history. J Natl Cancer Inst. 1983 Oct;71(4):711–716. [PubMed] [Google Scholar]
  8. Cramer D. W., Welch W. R. Determinants of ovarian cancer risk. II. Inferences regarding pathogenesis. J Natl Cancer Inst. 1983 Oct;71(4):717–721. [PubMed] [Google Scholar]
  9. Fathalla M. F. Incessant ovulation--a factor in ovarian neoplasia? Lancet. 1971 Jul 17;2(7716):163–163. doi: 10.1016/s0140-6736(71)92335-x. [DOI] [PubMed] [Google Scholar]
  10. Franceschi S., La Vecchia C., Booth M., Tzonou A., Negri E., Parazzini F., Trichopoulos D., Beral V. Pooled analysis of 3 European case-control studies of ovarian cancer: II. Age at menarche and at menopause. Int J Cancer. 1991 Aug 19;49(1):57–60. doi: 10.1002/ijc.2910490111. [DOI] [PubMed] [Google Scholar]
  11. Godard B., Foulkes W. D., Provencher D., Brunet J. S., Tonin P. N., Mes-Masson A. M., Narod S. A., Ghadirian P. Risk factors for familial and sporadic ovarian cancer among French Canadians: a case-control study. Am J Obstet Gynecol. 1998 Aug;179(2):403–410. doi: 10.1016/s0002-9378(98)70372-2. [DOI] [PubMed] [Google Scholar]
  12. Gwinn M. L., Lee N. C., Rhodes P. H., Layde P. M., Rubin G. L. Pregnancy, breast feeding, and oral contraceptives and the risk of epithelial ovarian cancer. J Clin Epidemiol. 1990;43(6):559–568. doi: 10.1016/0895-4356(90)90160-q. [V体育官网入口 - DOI] [PubMed] [Google Scholar]
  13. Hankinson S. E., Colditz G. A., Hunter D. J., Willett W. C., Stampfer M. J., Rosner B., Hennekens C. H., Speizer F. E. A prospective study of reproductive factors and risk of epithelial ovarian cancer. Cancer. 1995 Jul 15;76(2):284–290. doi: 10.1002/1097-0142(19950715)76:2<284::aid-cncr2820760219>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  14. Harlow B. L., Cramer D. W., Baron J. A., Titus-Ernstoff L., Greenberg E. R. Psychotropic medication use and risk of epithelial ovarian cancer. Cancer Epidemiol Biomarkers Prev. 1998 Aug;7(8):697–702. [PubMed] [Google Scholar]
  15. Harlow S. D., Ephross S. A. Epidemiology of menstruation and its relevance to women's health. Epidemiol Rev. 1995;17(2):265–286. doi: 10.1093/oxfordjournals.epirev.a036193. [DOI] [PubMed] [Google Scholar]
  16. Hartge P., Hoover R., McGowan L., Lesher L., Norris H. J. Menopause and ovarian cancer. Am J Epidemiol. 1988 May;127(5):990–998. doi: 10.1093/oxfordjournals.aje.a114902. [DOI] [PubMed] [Google Scholar]
  17. Hartge P., Schiffman M. H., Hoover R., McGowan L., Lesher L., Norris H. J. A case-control study of epithelial ovarian cancer. Am J Obstet Gynecol. 1989 Jul;161(1):10–16. doi: 10.1016/0002-9378(89)90221-4. [DOI] [PubMed] [Google Scholar]
  18. Kvåle G., Heuch I., Nilssen S., Beral V. Reproductive factors and risk of ovarian cancer: a prospective study. Int J Cancer. 1988 Aug 15;42(2):246–251. doi: 10.1002/ijc.2910420217. [DOI] [PubMed] [Google Scholar]
  19. La Vecchia C., Decarli A., Franceschi S., Regallo M., Tognoni G. Age at first birth and the risk of epithelial ovarian cancer. J Natl Cancer Inst. 1984 Sep;73(3):663–666. [VSports注册入口 - PubMed] [Google Scholar]
  20. McGowan L., Norris H. J., Hartge P., Hoover R., Lesher L. Risk factors in ovarian cancer. Eur J Gynaecol Oncol. 1988;9(3):195–199. [PubMed] [Google Scholar]
  21. Negri E., Franceschi S., Tzonou A., Booth M., La Vecchia C., Parazzini F., Beral V., Boyle P., Trichopoulos D. Pooled analysis of 3 European case-control studies: I. Reproductive factors and risk of epithelial ovarian cancer. Int J Cancer. 1991 Aug 19;49(1):50–56. doi: 10.1002/ijc.2910490110. [DOI] [PubMed] [Google Scholar]
  22. Ness R. B., Cottreau C. Possible role of ovarian epithelial inflammation in ovarian cancer. J Natl Cancer Inst. 1999 Sep 1;91(17):1459–1467. doi: 10.1093/jnci/91.17.1459. [DOI] [PubMed] [Google Scholar]
  23. Parazzini F., La Vecchia C., Negri E., Gentile A. Menstrual factors and the risk of epithelial ovarian cancer. J Clin Epidemiol. 1989;42(5):443–448. doi: 10.1016/0895-4356(89)90134-0. ["VSports注册入口" DOI] [PubMed] [Google Scholar]
  24. Polychronopoulou A., Tzonou A., Hsieh C. C., Kaprinis G., Rebelakos A., Toupadaki N., Trichopoulos D. Reproductive variables, tobacco, ethanol, coffee and somatometry as risk factors for ovarian cancer. Int J Cancer. 1993 Sep 30;55(3):402–407. doi: 10.1002/ijc.2910550312. [DOI] [PubMed] [Google Scholar]
  25. Purdie D., Green A., Bain C., Siskind V., Ward B., Hacker N., Quinn M., Wright G., Russell P., Susil B. Reproductive and other factors and risk of epithelial ovarian cancer: an Australian case-control study. Survey of Women's Health Study Group. Int J Cancer. 1995 Sep 15;62(6):678–684. doi: 10.1002/ijc.2910620606. [DOI] [PubMed] [Google Scholar]
  26. Risch H. A. Hormonal etiology of epithelial ovarian cancer, with a hypothesis concerning the role of androgens and progesterone. J Natl Cancer Inst. 1998 Dec 2;90(23):1774–1786. doi: 10.1093/jnci/90.23.1774. [DOI] [PubMed] [Google Scholar]
  27. Risch H. A., Marrett L. D., Howe G. R. Parity, contraception, infertility, and the risk of epithelial ovarian cancer. Am J Epidemiol. 1994 Oct 1;140(7):585–597. doi: 10.1093/oxfordjournals.aje.a117296. [DOI] [PubMed] [Google Scholar]
  28. Risch H. A., Marrett L. D., Jain M., Howe G. R. Differences in risk factors for epithelial ovarian cancer by histologic type. Results of a case-control study. Am J Epidemiol. 1996 Aug 15;144(4):363–372. doi: 10.1093/oxfordjournals.aje.a008937. [DOI (VSports手机版)] [PubMed] [Google Scholar]
  29. Risch H. A., Weiss N. S., Lyon J. L., Daling J. R., Liff J. M. Events of reproductive life and the incidence of epithelial ovarian cancer. Am J Epidemiol. 1983 Feb;117(2):128–139. doi: 10.1093/oxfordjournals.aje.a113523. [DOI] [PubMed] [Google Scholar]
  30. Rosenblatt K. A., Thomas D. B. Lactation and the risk of epithelial ovarian cancer. The WHO Collaborative Study of Neoplasia and Steroid Contraceptives. Int J Epidemiol. 1993 Apr;22(2):192–197. doi: 10.1093/ije/22.2.192. [DOI] [PubMed] [Google Scholar]
  31. Salazar-Martinez E., Lazcano-Ponce E. C., Gonzalez Lira-Lira G., Escudero-De los Rios P., Salmeron-Castro J., Hernandez-Avila M. Reproductive factors of ovarian and endometrial cancer risk in a high fertility population in Mexico. Cancer Res. 1999 Aug 1;59(15):3658–3662. [PubMed] [Google Scholar]
  32. Thomas H. V., Murphy M. F., Key T. J., Fentiman I. S., Allen D. S., Kinlen L. J. Pregnancy and menstrual hormone levels in mothers of twins compared to mothers of singletons. Ann Hum Biol. 1998 Jan-Feb;25(1):69–75. doi: 10.1080/03014469800005432. ["VSports最新版本" DOI] [PubMed] [Google Scholar]
  33. Vihko R., Apter D. Endocrine characteristics of adolescent menstrual cycles: impact of early menarche. J Steroid Biochem. 1984 Jan;20(1):231–236. doi: 10.1016/0022-4731(84)90209-7. [DOI] [PubMed] [Google Scholar]
  34. Whittemore A. S., Harris R., Itnyre J. Characteristics relating to ovarian cancer risk: collaborative analysis of 12 US case-control studies. II. Invasive epithelial ovarian cancers in white women. Collaborative Ovarian Cancer Group. Am J Epidemiol. 1992 Nov 15;136(10):1184–1203. doi: 10.1093/oxfordjournals.aje.a116427. [DOI] [PubMed] [Google Scholar]
  35. Whittemore A. S. Personal characteristics relating to risk of invasive epithelial ovarian cancer in older women in the United States. Cancer. 1993 Jan 15;71(2 Suppl):558–565. doi: 10.1002/cncr.2820710211. ["VSports手机版" DOI] [PubMed] [Google Scholar]
  36. Whittemore A. S., Wu M. L., Paffenbarger R. S., Jr, Sarles D. L., Kampert J. B., Grosser S., Jung D. L., Ballon S., Hendrickson M. Personal and environmental characteristics related to epithelial ovarian cancer. II. Exposures to talcum powder, tobacco, alcohol, and coffee. Am J Epidemiol. 1988 Dec;128(6):1228–1240. doi: 10.1093/oxfordjournals.aje.a115077. [DOI] [PubMed] [Google Scholar]
  37. Wu M. L., Whittemore A. S., Paffenbarger R. S., Jr, Sarles D. L., Kampert J. B., Grosser S., Jung D. L., Ballon S., Hendrickson M., Mohle-Boetani J. Personal and environmental characteristics related to epithelial ovarian cancer. I. Reproductive and menstrual events and oral contraceptive use. Am J Epidemiol. 1988 Dec;128(6):1216–1227. doi: 10.1093/oxfordjournals.aje.a115076. [DOI] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES