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Cancer Causes Control. 2017 May;28(5):405-414. doi: 10.1007/s10552-017-0853-7. Epub 2017 Mar 2.

Lifetime number of ovulatory cycles and epithelial ovarian cancer risk in African American women.

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Department of Public Health Sciences, University of Virginia, 800765, Charlottesville, VA, 22903, USA.
Department of Community and Family Medicine, Duke University Medical Center, 2424 Erwin Rd., Suite 602, Durham, NC, 27705, USA.
Hollings Cancer Center and Department of Public Health Sciences, Medical University of South Carolina, 68 President St., Bioengineering Building 103, Charleston, SC, 29425, USA.
Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, 195 Little Albany St., New Brunswick, NJ, 08903, USA.
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, 2-526 Wolstein Research Building, 2103 Cornell Rd., Cleveland, OH, 44106, USA.
Cancer Prevention and Population Sciences Program, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
Department of Oncology and the Karmanos Cancer Institute Population Studies and Disparities Research Program, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA.
Division of Preventive Medicine, University of Alabama at Birmingham, Medical Towers 611, 1717 11th Ave. South, Birmingham, AL, 35205, USA.
Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, 2020 Gravier St. 3rd Floor, New Orleans, LA, 70112, USA.
Department of Medicine, University of Tennessee Graduate School of Medicine, 1924 Alcola Highway Box U-114, Knoxville, TN, 37920, USA.
Department of Public Health Sciences, University of Virginia, 800765, Charlottesville, VA, 22903, USA.



Incessant ovulation has been consistently linked to epithelial ovarian cancer (EOC). Although reproductive characteristics differ substantially by race, the association between incessant ovulation and EOC has been evaluated only in populations of predominantly white women. In the present study, we examined the association between lifetime number of ovulatory cycles (LOCs) and EOC risk among African American (AA) women.


We used data from 534 cases and 722 controls enrolled in the African American Cancer Epidemiology Study. LOCs were determined using the standard method, with modifications to include episodes of irregular or missed periods. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between LOCs and EOC risk overall and by age, while adjusting for appropriate confounders.


The mean number of LOCs was 378.2 ± 105.8 for cases and 346.4 ± 117.3 for controls. Women in the highest tertile of LOCs had 59% higher odds of EOC compared to women in the lowest tertile (OR = 1.59; 95% CI = 1.15-2.20). When examining this relationship by age, the positive association with EOC was stronger among women <50 years of age (OR for highest vs. lowest tertile = 2.61; 95% CI = 1.15-5.94), followed by women aged 50-60 years (OR = 2.27; 95% CI = 1.30-3.94). Yet, no association was present among women aged >60 years (OR = 0.79; 95% CI = 0.45-1.40).


In a population of AA women, we observed a positive association between LOCs and EOC risk, providing further support for the hypothesis that incessant ovulation contributes to the etiology of EOC.


African American women; Lifetime ovulatory cycles; Ovarian cancer; Ovulation

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