Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women.
Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women.
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DOI：
10.1002/ijc.31581
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发表时间：
2018-10-15
影响因子：
6.4
通讯作者：
Glimelius I
中科院分区：
文献类型：
--
作者：
Sköld C;Bjørge T;Ekbom A;Engeland A;Gissler M;Grotmol T;Madanat-Harjuoja L;Gulbech Ording A;Stephansson O;Trabert B;Tretli S;Troisi R;Sørensen HT;Glimelius I
上皮性卵巢癌是一种病因不明的致命性疾病。较高的产次与卵巢癌风险降低有关。然而，在经产妇女中，与怀孕有关的因素对风险的影响尚不清楚。这项基于人群的病例对照研究包括1967-2013年期间丹麦、芬兰、挪威和瑞典的所有经产卵巢上皮癌妇女（n= 10，957）和多达10名匹配对照（n= 107，864）。我们使用条件Logistic回归来估计组织学亚型的妊娠相关因素和卵巢癌风险的比值比（OR）和95%置信区间（CI）。早产与风险增加相关[妊娠时间（末次妊娠）≤30周vs 39-41周，OR 1.33（95%CI 1.06-1.67），经分娩次数调整]; OR随妊娠时间缩短而增加（趋势p <0.001）。初次和末次生育年龄较大与风险降低相关[初次生育：30-39岁vs <25岁：调整OR 0.76（95%CI 0.70-0.83）;末次生育：30-39岁vs <25岁：调整OR 0.76（95%CI 0.71-0.82）]。对于所有亚型，增加出生次数具有保护作用[≥4胎vs 1胎; OR 0.63（95%CI 0.59-0.68）]，透明细胞肿瘤最明显[OR 0.30，（95%CI 0.21-0.44），p异质性<0.001]。未观察到与多胎妊娠、先兆子痫或后代大小相关。总之，除了高产次，足月妊娠和高龄妊娠与卵巢癌风险降低有关。我们的研究结果支持细胞清除假说，即近期妊娠通过胎盘或卵巢激素介导的卵巢/输卵管上皮癌前细胞的清除提供保护。
Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy-related factors on risk is not well understood. This population-based case-control study included all parous women with epithelial ovarian cancer in Denmark, Finland, Norway and Sweden during 1967-2013 (n=10,957) and up to 10 matched controls (n=107,864). We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for pregnancy-related factors and ovarian cancer risk by histological subtype. Preterm delivery was associated with an increased risk [pregnancy length (last pregnancy) ≤30 versus 39-41 weeks, OR 1.33 (95%CI 1.06-1.67), adjusted for number of births]; the OR increased as pregnancy length decreased (p for trend<0.001). Older age at first and last birth were associated with a decreased risk [first birth: 30-39 versus <25 years: adjusted OR 0.76 (95%CI 0.70-0.83); last birth 30-39 versus <25 years: adjusted OR 0.76 (95%CI 0.71-0.82)]. Increasing number of births was protective [≥4 births versus 1; OR 0.63 (95%CI 0.59-0.68)] for all subtypes, most pronounced for clear-cell tumors [OR 0.30, (95%CI 0.21-0.44), p-heterogeneity<0.001]. No associations were observed for multiple pregnancies, preeclampsia or offspring size. In conclusion, in addition to high parity, full-term pregnancies and pregnancies at older ages were associated with decreased risk of ovarian cancer. Our findings favor the cell clearance hypothesis, i.e. a recent pregnancy provides protection by clearing of precancerous cells from the epithelium of the ovary/fallopian tubes, mediated by placental or ovarian hormones.
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影响因子：
3.8
作者：
Cnattingius, Sven;Eloranta, Sandra;Adami, Hans-Olov;Axelsson, Ove;Dickman, Paul W.;Hsieh, Chung-cheng;Mucci, Lorelei A.;Trichopoulos, Dimitrios;Lambe, Mats;Johansson, Anna L. V.
通讯作者：
Johansson, Anna L. V.
DOI：
10.1016/s1470-2045(12)70322-4
发表时间：
2012-09
期刊：
The Lancet. Oncology
影响因子：
--
作者：
Collaborative Group on Epidemiological Studies of Ovarian Cancer;Beral V;Gaitskell K;Hermon C;Moser K;Reeves G;Peto R
通讯作者：
Peto R
影响因子：
6.1
作者：
Merritt, M. A.;De Pari, M.;Terry, K. L.
通讯作者：
Terry, K. L.
影响因子：
168.9
作者：
Lambe, M;Wuu, J;Hsieh, CC
通讯作者：
Hsieh, CC
DOI：
10.1177/140349489001800209
发表时间：
1990-01-01
期刊：
SCANDINAVIAN JOURNAL OF SOCIAL MEDICINE
影响因子：
--
作者：
CNATTINGIUS, S;ERICSON, A;KALLEN, B
通讯作者：
KALLEN, B