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

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.

• Authors: Lauren C Peres, Harvey Risch, Kathryn L Terry, Penelope M Webb, Marc T Goodman, Anna H Wu, Anthony J Alberg, Elisa V Bandera, Jill Barnholtz-Sloan, Melissa L Bondy, Michele L Cote, Ellen Funkhouser, Patricia G Moorman, Edward S Peters, Ann G Schwartz, Paul D Terry, Ani Manichaikul, Sarah E Abbott, Fabian Camacho, Susan J Jordan, Christina M Nagle, Australian Ovarian Cancer Study Group, Mary Anne Rossing, Jennifer A Doherty, Francesmary Modugno, Kirsten Moysich, Roberta Ness, Andrew Berchuck, Linda Cook, Nhu Le, Angela Brooks-Wilson, Weiva Sieh, Alice Whittemore, Valerie McGuire, Joseph Rothstein, Hoda Anton-Culver, Argyrios Ziogas, Celeste L Pearce, Chiuchen Tseng, Malcom Pike, Joellen M Schildkraut, African American Cancer Epidemiology Study and the Ovarian Cancer Association Consortium
• Journal: International journal of epidemiology (Int J Epidemiol) Vol. 47 Issue 2 Pg. 460-472 (04 01 2018) ISSN: 1464-3685 [Electronic] England
• PMID: 29211900 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Ovarian Epithelial (ethnology)
• Case-Control Studies
• Ethnicity (statistics & numerical data)
• Female
• Humans
• Incidence
• Middle Aged
• Multivariate Analysis
• Ovarian Neoplasms (ethnology)
• Parity
• Pregnancy
• Prevalence
• Probability
• Risk Factors
• United States (epidemiology)
• Young Adult