Endometrioid and clear cell ovarian cancers - A comparative analysis of risk factors

Christina M. Nagle, Catherine M. Olsen, Penelope M. Webb, Susan J. Jordan, David C. Whiteman, Adèle C. Green

Research output: Contribution to journalArticlepeer-review

75 Scopus citations

Abstract

Endometrioid and clear cell subtypes of ovarian cancer are both known to be closely associated with endometriosis and endometrial pathology, and so have often been combined in studies of causation. We have examined these ovarian cancers separately for potentially distinct risk factors in our population-based, Australia-wide case control study of 142 women with incident invasive endometrioid, 90 with clear cell ovarian cancers and 1508 population controls. Multivariate logistic regression was used to calculated odds ratios (ORs) and 95% confidence intervals (CIs). Increasing parity, and hormonal contraceptive use for ≥5 years, strongly decreased the risks of both subtypes. Breast feeding and tubal ligation were also inversely associated, but significantly so only for the endometrioid subtype. As expected endometriosis increased the risk of both subtypes (OR 2.2, 95%CI 1.2-3.9 for endometrioid and OR 3.0, 95%CI 1.5-5.9 for clear cell). Obesity was associated only with clear cell cancers, where we observed a two-fold increased risk (OR 2.2, 95%CI 1.2-4.1). Also a significant trend of decreasing risk with increasing intensity of smoking (p trend 0.02) and education beyond high school was associated with decreased development of clear cell cancers only. Endometrioid and clear cell ovarian cancers have some shared as well as some distinct risk factors, and therefore should be considered separately in studies of ovarian cancer.

Original languageEnglish
Pages (from-to)2477-2484
Number of pages8
JournalEuropean Journal of Cancer
Volume44
Issue number16
DOIs
StatePublished - Nov 2008
Externally publishedYes

Bibliographical note

Funding Information:
Sources of support: The Australian Ovarian Cancer Study was supported by the US Army Medical Research and Materiel Command (DAMD17-01-1-0729), the National Health and Medical Research Council of Australia (199600), the Cancer Council Tasmania and Cancer Foundation of Western Australia. C.N., P.W., S.J. and D.W. are funded by the National Health and Medical Research Council of Australia and CO is funded by the University of Queensland.

Funding

Sources of support: The Australian Ovarian Cancer Study was supported by the US Army Medical Research and Materiel Command (DAMD17-01-1-0729), the National Health and Medical Research Council of Australia (199600), the Cancer Council Tasmania and Cancer Foundation of Western Australia. C.N., P.W., S.J. and D.W. are funded by the National Health and Medical Research Council of Australia and CO is funded by the University of Queensland.

FundersFunder number
National Health and Medical Research Council
National Health and Medical Research Council199600
Medical Research and Materiel CommandDAMD17-01-1-0729
Cancer Foundation of Western Australia
Cancer Council Tasmania
University of Queensland

    Keywords

    • Clear cell
    • Endometrioid
    • Histological subtype
    • Ovarian cancer
    • Risk factors

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