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Body size and the risk of ovarian cancer by hormone therapy use in the California Teachers Study cohort

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Abstract

Objective

To investigate whether obesity and hormone therapy (HT) are associated with ovarian cancer risk among women in the California Teachers Study cohort.

Methods

Of 56,091 women age ≥45 years, 277 developed epithelial ovarian cancer between 1995 and 2007. Multivariate Cox regression was performed.

Results

Among women who never used HT, greater adult weight gain, waist circumference and waist-to-height ratio, but not adult BMI, increased risk of ovarian cancer. Compared to women who never used HT and had a stable adult weight, risk of ovarian cancer was increased in women who gained ≥40 lb (relative risk (RR) 1.8, 95% confidence interval (CI): 1.0–3.0) or used HT for >5 years (RR 2.3 95% CI: 1.3–4.1). Having both exposures (RR 1.9, 95% CI: 0.99–3.5), however, did not increase risk more than having either alone. Results were similar for waist circumference and weight-to-height ratio; however, differences across HT groups were not statistically significant.

Conclusions

This study suggests that abdominal adiposity and weight gain, but not overall obesity, increase ovarian cancer risk and that there may be a threshold level beyond which additional hormones, whether exogenous or endogenous, do not result in additional elevation in risk. However, large pooled analyses are needed to confirm these findings.

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Acknowledgments

This research was supported by grant R01 CA77398 from the National Cancer Institute and contract 97-10500 from the California Breast Cancer Research Fund. The funding sources did not contribute to the design or conduct of the study, nor to the writing or submission of this manuscript. The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Sect. 103885; the National Cancer Institute’s Surveillance, Epidemiology and End Results Program under contract N01-PC-35136 awarded to the Cancer Prevention Institute of California (formerly the Northern California Cancer Center), contract N01-PC-35139 awarded to the University of Southern California, and contract N02-PC-15105 awarded to the Public Health Institute; and the Centers for Disease Control and Prevention’s National Program of Cancer Registries, under agreement #U55/CCR921930-02 awarded to the Public Health Institute. The ideas and opinions expressed herein are those of the authors and endorsement by the State of California, Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their contractors and subcontractors is not intended nor should be inferred. The authors would like to thank the CTS Steering Committee who are responsible for the formation and maintenance of the cohort within which this study was conducted but who did not directly contribute to the current paper: Hoda Anton-Culver, Christina A. Clarke, James V. Lacey Jr., Huiyan Ma, David O. Nelson, Susan L. Neuhausen, Rich Pinder, Frederick Schumacher, Daniel O. Stram, Sophia S. Wang, Dee W. West, and Argyrios Ziogas.

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Authors and Affiliations

  1. Cancer Prevention Institute of California, 2201 Walnut Avenue, Suite 300, Fremont, CA, 94538, USA

    Alison J. Canchola, Ellen T. Chang, Peggy Reynolds & Pamela L. Horn-Ross

  2. Division of Epidemiology, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA, USA

    Ellen T. Chang, Peggy Reynolds & Pamela L. Horn-Ross

  3. Division of Cancer Etiology, Department of Population Sciences, City of Hope National Medical Center, Duarte, CA, USA

    Leslie Bernstein & Katherine D. Henderson

  4. Department of Epidemiology, College of Health Sciences, University of California Irvine, Irvine, CA, USA

    Joan A. Largent

  5. Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA

    Dennis Deapen & Giske Ursin

  6. Department of Nutrition, University of Oslo, Oslo, Norway

    Giske Ursin

Authors
  1. Alison J. Canchola
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  2. Ellen T. Chang
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  3. Leslie Bernstein
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  4. Joan A. Largent
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  5. Peggy Reynolds
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  6. Dennis Deapen
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  7. Katherine D. Henderson
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  8. Giske Ursin
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  9. Pamela L. Horn-Ross
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Correspondence to Alison J. Canchola.

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Canchola, A.J., Chang, E.T., Bernstein, L. et al. Body size and the risk of ovarian cancer by hormone therapy use in the California Teachers Study cohort. Cancer Causes Control 21, 2241–2248 (2010). https://doi.org/10.1007/s10552-010-9647-x

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  • DOI: https://doi.org/10.1007/s10552-010-9647-x

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