General Obstetrics and Gynecology: GynecologyOral contraceptive use, reproductive history, and risk of epithelial ovarian cancer in women with and without endometriosis☆
Section snippets
Subjects
We pooled data on the history of endometriosis from 4 population-based, ovarian cancer case-controlled studies that recruited women from 4 regions of the United States from 1993 through 2001. Cases for the analyses represent women with ovarian cancer who participated in 1 of these 4 studies. Control subjects in our analyses are women without ovarian cancer who served as control subjects in the original studies. Specific descriptions of each study's methods are provided in the original
Results
Of the 2098 cases and 2953 control subjects, 177 cases (8.5%) and 184 control subjects (6.3%) reported a history of endometriosis. After adjustments were made for study site, OC duration, parity, age, tubal ligation, and family history of ovarian cancer, we found that women with endometriosis were more likely to have ovarian cancer than women without a history of the disease (adjusted OR, 1.32; 95% CI, 1.06-1.65). The association was greater for nulliparous women (adjusted OR, 1.75; 95% CI,
Comment
In this pooled analysis, the occurrence of ovarian cancer was a significant 30% higher among women who reported a history of endometriosis compared with those women who reported no such history. This association was greater in nulliparous women, which confirms that the association is likely due to the endometriosis and not the infertility or decreased parity caused by the endometriosis.16 Using oral contraceptives, bearing children, and having a tubal ligation reduced the risk of ovarian
Acknowledgements
We thank Dr Anna Wu for data collection in Los Angeles, Randi Koenig for her help with the manuscript, and Dr Jeffrey L. Eppinger for his help with this work.
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Supported in part by the National Cancer Institute grants K07-CA80668 (F.M.), R01CA61095 (R.B.N), R01-CA-58598 (M.T.G), N01-CN-67001 (M.T.G), R01-CA61093 (F.G.D.) and RO1 CA76016 (J.M.S.).