Tubal ligation and risk of ovarian cancer subtypes: A pooled analysis of case-control studies

Weiva Sieh, Shannon Salvador, Valerie McGuire, Rachel Palmieri Weber, Kathryn L. Terry, Mary Anne Rossing, Harvey Risch, Anna H. Wu, Penelope M. Webb, Kirsten Moysich, Jennifer A. Doherty, Anna Felberg, Dianne Miller, Susan J. Jordan, Marc T. Goodman, Galina Lurie, Jenny Chang-Claude, Anja Rudolph, Susanne Kru Kjær ̈ger, Allan JensenEstrid Høgdall, Elisa V. Bandera, Sara H. Olson, Melony G. King, Lorna Rodriguez-Rodriguez, Lambertus A. Kiemeney, Tamara Marees, Leon F. Massuger, Anne M. van Altena, Roberta B. Ness, Daniel W. Cramer, Malcolm C. Pike, Celeste Leigh Pearce, Andrew Berchuck, Joellen M. Schildkraut, Alice S. Whittemore

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Abstract

Background: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. Methods: We pooled primary data from 13 population-based case-control studies, including 10 157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13 904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. Results: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P<0.001),endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P<0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P<0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P1/4 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P<0.0001) and clear cell (P1/4 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. Conclusions: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.

Original languageEnglish (US)
Pages (from-to)579-589
Number of pages11
JournalInternational journal of epidemiology
Volume42
Issue number2
DOIs
StatePublished - Apr 2013

Fingerprint

Tubal Sterilization
Ovarian Neoplasms
Case-Control Studies
Neoplasms
Term Birth
Risk Reduction Behavior
Oral Contraceptives
Logistic Models
Odds Ratio
Population

All Science Journal Classification (ASJC) codes

  • Epidemiology

Keywords

  • Ovarian cancer
  • Tubal ligation
  • Tubal sterilization

Cite this

Sieh, W., Salvador, S., McGuire, V., Weber, R. P., Terry, K. L., Rossing, M. A., ... Whittemore, A. S. (2013). Tubal ligation and risk of ovarian cancer subtypes: A pooled analysis of case-control studies. International journal of epidemiology, 42(2), 579-589. https://doi.org/10.1093/ije/dyt042
Sieh, Weiva ; Salvador, Shannon ; McGuire, Valerie ; Weber, Rachel Palmieri ; Terry, Kathryn L. ; Rossing, Mary Anne ; Risch, Harvey ; Wu, Anna H. ; Webb, Penelope M. ; Moysich, Kirsten ; Doherty, Jennifer A. ; Felberg, Anna ; Miller, Dianne ; Jordan, Susan J. ; Goodman, Marc T. ; Lurie, Galina ; Chang-Claude, Jenny ; Rudolph, Anja ; Kjær ̈ger, Susanne Kru ; Jensen, Allan ; Høgdall, Estrid ; Bandera, Elisa V. ; Olson, Sara H. ; King, Melony G. ; Rodriguez-Rodriguez, Lorna ; Kiemeney, Lambertus A. ; Marees, Tamara ; Massuger, Leon F. ; van Altena, Anne M. ; Ness, Roberta B. ; Cramer, Daniel W. ; Pike, Malcolm C. ; Pearce, Celeste Leigh ; Berchuck, Andrew ; Schildkraut, Joellen M. ; Whittemore, Alice S. / Tubal ligation and risk of ovarian cancer subtypes : A pooled analysis of case-control studies. In: International journal of epidemiology. 2013 ; Vol. 42, No. 2. pp. 579-589.
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abstract = "Background: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. Methods: We pooled primary data from 13 population-based case-control studies, including 10 157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13 904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. Results: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95{\%} CI, 0.74-0.89; P<0.001),endometrioid (OR, 0.48; 95{\%} CI, 0.40-0.59; P<0.001), clear cell (OR, 0.52; 95{\%} CI, 0.40-0.67; P<0.001) and mucinous (OR, 0.68; 95{\%} CI, 0.52-0.89; P1/4 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P<0.0001) and clear cell (P1/4 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. Conclusions: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.",
keywords = "Ovarian cancer, Tubal ligation, Tubal sterilization",
author = "Weiva Sieh and Shannon Salvador and Valerie McGuire and Weber, {Rachel Palmieri} and Terry, {Kathryn L.} and Rossing, {Mary Anne} and Harvey Risch and Wu, {Anna H.} and Webb, {Penelope M.} and Kirsten Moysich and Doherty, {Jennifer A.} and Anna Felberg and Dianne Miller and Jordan, {Susan J.} and Goodman, {Marc T.} and Galina Lurie and Jenny Chang-Claude and Anja Rudolph and {Kj{\ae}r ̈ger}, {Susanne Kru} and Allan Jensen and Estrid H{\o}gdall and Bandera, {Elisa V.} and Olson, {Sara H.} and King, {Melony G.} and Lorna Rodriguez-Rodriguez and Kiemeney, {Lambertus A.} and Tamara Marees and Massuger, {Leon F.} and {van Altena}, {Anne M.} and Ness, {Roberta B.} and Cramer, {Daniel W.} and Pike, {Malcolm C.} and Pearce, {Celeste Leigh} and Andrew Berchuck and Schildkraut, {Joellen M.} and Whittemore, {Alice S.}",
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Sieh, W, Salvador, S, McGuire, V, Weber, RP, Terry, KL, Rossing, MA, Risch, H, Wu, AH, Webb, PM, Moysich, K, Doherty, JA, Felberg, A, Miller, D, Jordan, SJ, Goodman, MT, Lurie, G, Chang-Claude, J, Rudolph, A, Kjær ̈ger, SK, Jensen, A, Høgdall, E, Bandera, EV, Olson, SH, King, MG, Rodriguez-Rodriguez, L, Kiemeney, LA, Marees, T, Massuger, LF, van Altena, AM, Ness, RB, Cramer, DW, Pike, MC, Pearce, CL, Berchuck, A, Schildkraut, JM & Whittemore, AS 2013, 'Tubal ligation and risk of ovarian cancer subtypes: A pooled analysis of case-control studies', International journal of epidemiology, vol. 42, no. 2, pp. 579-589. https://doi.org/10.1093/ije/dyt042

Tubal ligation and risk of ovarian cancer subtypes : A pooled analysis of case-control studies. / Sieh, Weiva; Salvador, Shannon; McGuire, Valerie; Weber, Rachel Palmieri; Terry, Kathryn L.; Rossing, Mary Anne; Risch, Harvey; Wu, Anna H.; Webb, Penelope M.; Moysich, Kirsten; Doherty, Jennifer A.; Felberg, Anna; Miller, Dianne; Jordan, Susan J.; Goodman, Marc T.; Lurie, Galina; Chang-Claude, Jenny; Rudolph, Anja; Kjær ̈ger, Susanne Kru; Jensen, Allan; Høgdall, Estrid; Bandera, Elisa V.; Olson, Sara H.; King, Melony G.; Rodriguez-Rodriguez, Lorna; Kiemeney, Lambertus A.; Marees, Tamara; Massuger, Leon F.; van Altena, Anne M.; Ness, Roberta B.; Cramer, Daniel W.; Pike, Malcolm C.; Pearce, Celeste Leigh; Berchuck, Andrew; Schildkraut, Joellen M.; Whittemore, Alice S.

In: International journal of epidemiology, Vol. 42, No. 2, 04.2013, p. 579-589.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Tubal ligation and risk of ovarian cancer subtypes

T2 - A pooled analysis of case-control studies

AU - Sieh, Weiva

AU - Salvador, Shannon

AU - McGuire, Valerie

AU - Weber, Rachel Palmieri

AU - Terry, Kathryn L.

AU - Rossing, Mary Anne

AU - Risch, Harvey

AU - Wu, Anna H.

AU - Webb, Penelope M.

AU - Moysich, Kirsten

AU - Doherty, Jennifer A.

AU - Felberg, Anna

AU - Miller, Dianne

AU - Jordan, Susan J.

AU - Goodman, Marc T.

AU - Lurie, Galina

AU - Chang-Claude, Jenny

AU - Rudolph, Anja

AU - Kjær ̈ger, Susanne Kru

AU - Jensen, Allan

AU - Høgdall, Estrid

AU - Bandera, Elisa V.

AU - Olson, Sara H.

AU - King, Melony G.

AU - Rodriguez-Rodriguez, Lorna

AU - Kiemeney, Lambertus A.

AU - Marees, Tamara

AU - Massuger, Leon F.

AU - van Altena, Anne M.

AU - Ness, Roberta B.

AU - Cramer, Daniel W.

AU - Pike, Malcolm C.

AU - Pearce, Celeste Leigh

AU - Berchuck, Andrew

AU - Schildkraut, Joellen M.

AU - Whittemore, Alice S.

PY - 2013/4

Y1 - 2013/4

N2 - Background: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. Methods: We pooled primary data from 13 population-based case-control studies, including 10 157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13 904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. Results: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P<0.001),endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P<0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P<0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P1/4 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P<0.0001) and clear cell (P1/4 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. Conclusions: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.

AB - Background: Tubal ligation is a protective factor for ovarian cancer, but it is unknown whether this protection extends to all invasive histological subtypes or borderline tumors. We undertook an international collaborative study to examine the association between tubal ligation and ovarian cancer subtypes. Methods: We pooled primary data from 13 population-based case-control studies, including 10 157 patients with ovarian cancer (7942 invasive; 2215 borderline) and 13 904 control women. Invasive cases were analysed by histological type, grade and stage, and borderline cases were analysed by histological type. Pooled odds ratios were estimated using conditional logistic regression to match on site, race/ethnicity and age categories, and to adjust for age, oral contraceptive use duration and number of full-term births. Results: Tubal ligation was associated with significantly reduced risks of invasive serous (OR, 0.81; 95% CI, 0.74-0.89; P<0.001),endometrioid (OR, 0.48; 95% CI, 0.40-0.59; P<0.001), clear cell (OR, 0.52; 95% CI, 0.40-0.67; P<0.001) and mucinous (OR, 0.68; 95% CI, 0.52-0.89; P1/4 0.005) cancers. The magnitude of risk reduction was significantly greater for invasive endometrioid (P<0.0001) and clear cell (P1/4 0.0018) than for serous cancer. No significant associations were found with borderline serous or mucinous tumours. Conclusions: We found that the protective effects of tubal ligation on ovarian cancer risk were subtype-specific. These findings provide insights into distinct aetiologies of ovarian cancer subtypes and mechanisms underlying the protective effects of tubal ligation.

KW - Ovarian cancer

KW - Tubal ligation

KW - Tubal sterilization

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DO - https://doi.org/10.1093/ije/dyt042

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