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Cancer Epidemiol Biomarkers Prev. 2018 Feb;27(2):174-182. doi: 10.1158/1055-9965.EPI-17-0655. Epub 2017 Nov 15.

Polycystic Ovary Syndrome, Oligomenorrhea, and Risk of Ovarian Cancer Histotypes: Evidence from the Ovarian Cancer Association Consortium.

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Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Dana Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts.
Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
Australian Ovarian Cancer Study Group, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut.
Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington.
Department of Epidemiology, University of Washington, Seattle, Washington.
Huntsman Cancer Institute, Department of Population Health Sciences, University of Utah, Salt Lake City, Utah.
Cancer Prevention and Control, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Community and Population Health Research Institute, Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, California.
Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.
The University of Texas School of Public Health, Houston, Texas.
Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York.
Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
Department of Public Health Sciences, The University of Virginia, Charlottesville, Virginia.
Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina.
Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
Cancer Prevention and Control Program, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey.
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland.
Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada.
Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida.
Public Health Ontario, Toronto, Canada.
Department of Epidemiology, University of California Irvine, Irvine, California.
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan.
Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, California.


Background: Polycystic ovary syndrome (PCOS), and one of its distinguishing characteristics, oligomenorrhea, have both been associated with ovarian cancer risk in some but not all studies. However, these associations have been rarely examined by ovarian cancer histotypes, which may explain the lack of clear associations reported in previous studies.Methods: We analyzed data from 14 case-control studies including 16,594 women with invasive ovarian cancer (n = 13,719) or borderline ovarian disease (n = 2,875) and 17,718 controls. Adjusted study-specific ORs were calculated using logistic regression and combined using random-effects meta-analysis. Pooled histotype-specific ORs were calculated using polytomous logistic regression.Results: Women reporting menstrual cycle length >35 days had decreased risk of invasive ovarian cancer compared with women reporting cycle length ≤35 days [OR = 0.70; 95% confidence interval (CI) = 0.58-0.84]. Decreased risk of invasive ovarian cancer was also observed among women who reported irregular menstrual cycles compared with women with regular cycles (OR = 0.83; 95% CI = 0.76-0.89). No significant association was observed between self-reported PCOS and invasive ovarian cancer risk (OR = 0.87; 95% CI = 0.65-1.15). There was a decreased risk of all individual invasive histotypes for women with menstrual cycle length >35 days, but no association with serous borderline tumors (Pheterogeneity = 0.006). Similarly, we observed decreased risks of most invasive histotypes among women with irregular cycles, but an increased risk of borderline serous and mucinous tumors (Pheterogeneity < 0.0001).Conclusions: Our results suggest that menstrual cycle characteristics influence ovarian cancer risk differentially based on histotype.Impact: These results highlight the importance of examining ovarian cancer risk factors associations by histologic subtype. Cancer Epidemiol Biomarkers Prev; 27(2); 174-82. ©2017 AACR.

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