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Int J Epidemiol. 2018 Apr 1;47(2):460-472. doi: 10.1093/ije/dyx252.

Racial/ethnic differences in the epidemiology of ovarian cancer: a pooled analysis of 12 case-control studies.

Author information

1
Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA.
2
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
3
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, MA, USA.
4
Harvard T. H. Chan School of Public Health, Boston, MA, USA.
5
Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
6
Samuel Oschin Comprehensive Cancer Institute.
7
Community and Population Health Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
8
Department of Preventive Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.
9
Hollings Cancer Center, Medical University of South Carolina, Charleston, SC, USA.
10
Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA.
11
Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
12
Cancer Prevention and Population Sciences Program, Baylor College of Medicine, Houston, TX, USA.
13
Karmanos Cancer Institute Population Studies and Disparities Research Program, Wayne State University School of Medicine, Detroit, MI, USA.
14
Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.
15
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
16
Department of Epidemiology, Louisiana State University Health Sciences Center School of Public Health, New Orleans, LA, USA.
17
Graduate School of Medicine, University of Tennessee Medical Center, Knoxville, TN, USA.
18
Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA.
19
Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
20
Department of Epidemiology, University of Washington, Seattle, WA, USA.
21
Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
22
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
23
Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
24
Ovarian Cancer Center of Excellence, Magee-Womens Research Institute and University of Pittsburgh Cancer Institute, Pittsburgh, PA, USA.
25
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
26
University of Texas School of Public Health, Houston, TX, USA.
27
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
28
Division of Epidemiology and Biostatistics, University of New Mexico, Albuquerque, NM, USA.
29
Cancer Control Research.
30
Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, Vancouver, BC, Canada.
31
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
32
Department of Population Health Science and Policy and Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
33
Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA.
34
Department of Epidemiology.
35
Genetic Epidemiology Research Institute, University of California Irvine, Irvine, CA, USA.
36
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
37
Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.

Abstract

Background:

Ovarian cancer incidence differs substantially by race/ethnicity, but the reasons for this are not well understood. Data were pooled from the African American Cancer Epidemiology Study (AACES) and 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC) to examine racial/ethnic differences in epidemiological characteristics with suspected involvement in epithelial ovarian cancer (EOC) aetiology.

Methods:

We used multivariable logistic regression to estimate associations for 17 reproductive, hormonal and lifestyle characteristics and EOC risk by race/ethnicity among 10 924 women with invasive EOC (8918 Non-Hispanic Whites, 433 Hispanics, 911 Blacks, 662 Asian/Pacific Islanders) and 16 150 controls (13 619 Non-Hispanic Whites, 533 Hispanics, 1233 Blacks, 765 Asian/Pacific Islanders). Likelihood ratio tests were used to evaluate heterogeneity in the risk factor associations by race/ethnicity.

Results:

We observed statistically significant racial/ethnic heterogeneity for hysterectomy and EOC risk (P = 0.008), where the largest odds ratio (OR) was observed in Black women [OR = 1.64, 95% confidence interval (CI) = 1.34-2.02] compared with other racial/ethnic groups. Although not statistically significant, the associations for parity, first-degree family history of ovarian or breast cancer, and endometriosis varied by race/ethnicity. Asian/Pacific Islanders had the greatest magnitude of association for parity (≥3 births: OR = 0.38, 95% CI = 0.28-0.54), and Black women had the largest ORs for family history (OR = 1.77, 95% CI = 1.42-2.21) and endometriosis (OR = 2.42, 95% CI = 1.65-3.55).

Conclusions:

Although racial/ethnic heterogeneity was observed for hysterectomy, our findings support the validity of EOC risk factors across all racial/ethnic groups, and further suggest that any racial/ethnic population with a higher prevalence of a modifiable risk factor should be targeted to disseminate information about prevention.

PMID:
29211900
PMCID:
PMC5913601
DOI:
10.1093/ije/dyx252
[Indexed for MEDLINE]
Free PMC Article

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