Characteristics relating to ovarian cancer risk: Collaborative analysis of 12 us case-control studies: IV. The pathogenesis of epithlial ovarian cancer

Alice S. Whittemore, Robin B Harris, Jacqueline Ltnyre

Research output: Contribution to journalArticle

244 Citations (Scopus)

Abstract

Two hypotheses have been proposed to explain the reduced risk of epithelial ovarian cancer associated with pregnancy and oral contraceptive use. The first states that some sequelae of ovulation increase the likelihood of malignancy and that pregnancies and oral contraceptives protect by suppressing ovulation. The second hypothesis states that circulating levels of pituitary gonadotropins increase the risk of malignancy and that pregnancies and oral contraceptives protect by suppressing secretion of these hormones. The authors evaluate the two hypotheses in light of combined data from 12 United States case-oxitrol studies of epithelial ovarian cancer in white women conducted from 1956 to 1986. While a number of observations support both hypotheses, there are exceptions. Differential risk reduction associated with pregnancy and oral contraceptive use (pregnancy being the more effective in young women and the less effective in older women) conflicts with the first "ovulation" hypothesis, while reduced risk associated with breast feeding and absence of altered risk associated with estrogen replacement therapy conflicts with the second "gonadotropin" hypothesis. Several findings would not have been predicted by either hypothesis, e.g., only weak trends relate cancer risk to age at menarche, and, among older women, no clear trends relate risk to age at menopause. Odds ratio attenuation due to errors in reporting personal characteristics may be responsible for some of these inconsistencies. Multidisciplinary research is needed to clarify the etkrfogic roles of ovulation and gonadotropin stimulation, both of which may enhance carcinogenesis in the ovarian epithelium. Am J Epidemiol 1992: 136: 1212-20

Original languageEnglish (US)
Pages (from-to)1212-1220
Number of pages9
JournalAmerican Journal of Epidemiology
Volume136
Issue number10
StatePublished - Nov 15 1992
Externally publishedYes

Fingerprint

Ovarian Neoplasms
Case-Control Studies
Oral Contraceptives
Ovulation
Pregnancy
Gonadotropins
Pituitary Gonadotropins
Neoplasms
Menarche
Estrogen Replacement Therapy
Risk Reduction Behavior
Menopause
Breast Feeding
Carcinogenesis
Epithelium
Odds Ratio
Hormones
Research
Ovarian epithelial cancer
Conflict (Psychology)

Keywords

  • Gonadotropins
  • Ovarian neoplasms
  • Ovulation
  • Reproductions

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Epidemiology

Cite this

Characteristics relating to ovarian cancer risk : Collaborative analysis of 12 us case-control studies: IV. The pathogenesis of epithlial ovarian cancer. / Whittemore, Alice S.; Harris, Robin B; Ltnyre, Jacqueline.

In: American Journal of Epidemiology, Vol. 136, No. 10, 15.11.1992, p. 1212-1220.

Research output: Contribution to journalArticle

@article{36b6cdcc843f471fadef7589054417d4,
title = "Characteristics relating to ovarian cancer risk: Collaborative analysis of 12 us case-control studies: IV. The pathogenesis of epithlial ovarian cancer",
abstract = "Two hypotheses have been proposed to explain the reduced risk of epithelial ovarian cancer associated with pregnancy and oral contraceptive use. The first states that some sequelae of ovulation increase the likelihood of malignancy and that pregnancies and oral contraceptives protect by suppressing ovulation. The second hypothesis states that circulating levels of pituitary gonadotropins increase the risk of malignancy and that pregnancies and oral contraceptives protect by suppressing secretion of these hormones. The authors evaluate the two hypotheses in light of combined data from 12 United States case-oxitrol studies of epithelial ovarian cancer in white women conducted from 1956 to 1986. While a number of observations support both hypotheses, there are exceptions. Differential risk reduction associated with pregnancy and oral contraceptive use (pregnancy being the more effective in young women and the less effective in older women) conflicts with the first {"}ovulation{"} hypothesis, while reduced risk associated with breast feeding and absence of altered risk associated with estrogen replacement therapy conflicts with the second {"}gonadotropin{"} hypothesis. Several findings would not have been predicted by either hypothesis, e.g., only weak trends relate cancer risk to age at menarche, and, among older women, no clear trends relate risk to age at menopause. Odds ratio attenuation due to errors in reporting personal characteristics may be responsible for some of these inconsistencies. Multidisciplinary research is needed to clarify the etkrfogic roles of ovulation and gonadotropin stimulation, both of which may enhance carcinogenesis in the ovarian epithelium. Am J Epidemiol 1992: 136: 1212-20",
keywords = "Gonadotropins, Ovarian neoplasms, Ovulation, Reproductions",
author = "Whittemore, {Alice S.} and Harris, {Robin B} and Jacqueline Ltnyre",
year = "1992",
month = "11",
day = "15",
language = "English (US)",
volume = "136",
pages = "1212--1220",
journal = "American Journal of Epidemiology",
issn = "0002-9262",
publisher = "Oxford University Press",
number = "10",

}

TY - JOUR

T1 - Characteristics relating to ovarian cancer risk

T2 - Collaborative analysis of 12 us case-control studies: IV. The pathogenesis of epithlial ovarian cancer

AU - Whittemore, Alice S.

AU - Harris, Robin B

AU - Ltnyre, Jacqueline

PY - 1992/11/15

Y1 - 1992/11/15

N2 - Two hypotheses have been proposed to explain the reduced risk of epithelial ovarian cancer associated with pregnancy and oral contraceptive use. The first states that some sequelae of ovulation increase the likelihood of malignancy and that pregnancies and oral contraceptives protect by suppressing ovulation. The second hypothesis states that circulating levels of pituitary gonadotropins increase the risk of malignancy and that pregnancies and oral contraceptives protect by suppressing secretion of these hormones. The authors evaluate the two hypotheses in light of combined data from 12 United States case-oxitrol studies of epithelial ovarian cancer in white women conducted from 1956 to 1986. While a number of observations support both hypotheses, there are exceptions. Differential risk reduction associated with pregnancy and oral contraceptive use (pregnancy being the more effective in young women and the less effective in older women) conflicts with the first "ovulation" hypothesis, while reduced risk associated with breast feeding and absence of altered risk associated with estrogen replacement therapy conflicts with the second "gonadotropin" hypothesis. Several findings would not have been predicted by either hypothesis, e.g., only weak trends relate cancer risk to age at menarche, and, among older women, no clear trends relate risk to age at menopause. Odds ratio attenuation due to errors in reporting personal characteristics may be responsible for some of these inconsistencies. Multidisciplinary research is needed to clarify the etkrfogic roles of ovulation and gonadotropin stimulation, both of which may enhance carcinogenesis in the ovarian epithelium. Am J Epidemiol 1992: 136: 1212-20

AB - Two hypotheses have been proposed to explain the reduced risk of epithelial ovarian cancer associated with pregnancy and oral contraceptive use. The first states that some sequelae of ovulation increase the likelihood of malignancy and that pregnancies and oral contraceptives protect by suppressing ovulation. The second hypothesis states that circulating levels of pituitary gonadotropins increase the risk of malignancy and that pregnancies and oral contraceptives protect by suppressing secretion of these hormones. The authors evaluate the two hypotheses in light of combined data from 12 United States case-oxitrol studies of epithelial ovarian cancer in white women conducted from 1956 to 1986. While a number of observations support both hypotheses, there are exceptions. Differential risk reduction associated with pregnancy and oral contraceptive use (pregnancy being the more effective in young women and the less effective in older women) conflicts with the first "ovulation" hypothesis, while reduced risk associated with breast feeding and absence of altered risk associated with estrogen replacement therapy conflicts with the second "gonadotropin" hypothesis. Several findings would not have been predicted by either hypothesis, e.g., only weak trends relate cancer risk to age at menarche, and, among older women, no clear trends relate risk to age at menopause. Odds ratio attenuation due to errors in reporting personal characteristics may be responsible for some of these inconsistencies. Multidisciplinary research is needed to clarify the etkrfogic roles of ovulation and gonadotropin stimulation, both of which may enhance carcinogenesis in the ovarian epithelium. Am J Epidemiol 1992: 136: 1212-20

KW - Gonadotropins

KW - Ovarian neoplasms

KW - Ovulation

KW - Reproductions

UR - http://www.scopus.com/inward/record.url?scp=0027050477&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027050477&partnerID=8YFLogxK

M3 - Article

C2 - 1476143

AN - SCOPUS:0027050477

VL - 136

SP - 1212

EP - 1220

JO - American Journal of Epidemiology

JF - American Journal of Epidemiology

SN - 0002-9262

IS - 10

ER -