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Racial/ethnic differences in the epidemiology of ovarian cancer: a pooled analysis of 12 case-control studies.

  • Author(s): Peres, Lauren C
  • Risch, Harvey
  • Terry, Kathryn L
  • Webb, Penelope M
  • Goodman, Marc T
  • Wu, Anna H
  • Alberg, Anthony J
  • Bandera, Elisa V
  • Barnholtz-Sloan, Jill
  • Bondy, Melissa L
  • Cote, Michele L
  • Funkhouser, Ellen
  • Moorman, Patricia G
  • Peters, Edward S
  • Schwartz, Ann G
  • Terry, Paul D
  • Manichaikul, Ani
  • Abbott, Sarah E
  • Camacho, Fabian
  • Jordan, Susan J
  • Nagle, Christina M
  • Australian Ovarian Cancer Study Group
  • Rossing, Mary Anne
  • Doherty, Jennifer A
  • Modugno, Francesmary
  • Moysich, Kirsten
  • Ness, Roberta
  • Berchuck, Andrew
  • Cook, Linda
  • Le, Nhu
  • Brooks-Wilson, Angela
  • Sieh, Weiva
  • Whittemore, Alice
  • McGuire, Valerie
  • Rothstein, Joseph
  • Anton-Culver, Hoda
  • Ziogas, Argyrios
  • Pearce, Celeste L
  • Tseng, Chiuchen
  • Pike, Malcom
  • Schildkraut, Joellen M
  • African American Cancer Epidemiology Study and the Ovarian Cancer Association Consortium
  • et al.
Abstract

Background:Ovarian cancer incidence differs substantially by race/ethnicity, but the reasons for this are not well understood. Data were pooled from the African American Cancer Epidemiology Study (AACES) and 11 case-control studies in the Ovarian Cancer Association Consortium (OCAC) to examine racial/ethnic differences in epidemiological characteristics with suspected involvement in epithelial ovarian cancer (EOC) aetiology. Methods:We used multivariable logistic regression to estimate associations for 17 reproductive, hormonal and lifestyle characteristics and EOC risk by race/ethnicity among 10 924 women with invasive EOC (8918 Non-Hispanic Whites, 433 Hispanics, 911 Blacks, 662 Asian/Pacific Islanders) and 16 150 controls (13 619 Non-Hispanic Whites, 533 Hispanics, 1233 Blacks, 765 Asian/Pacific Islanders). Likelihood ratio tests were used to evaluate heterogeneity in the risk factor associations by race/ethnicity. Results:We observed statistically significant racial/ethnic heterogeneity for hysterectomy and EOC risk (P = 0.008), where the largest odds ratio (OR) was observed in Black women [OR = 1.64, 95% confidence interval (CI) = 1.34-2.02] compared with other racial/ethnic groups. Although not statistically significant, the associations for parity, first-degree family history of ovarian or breast cancer, and endometriosis varied by race/ethnicity. Asian/Pacific Islanders had the greatest magnitude of association for parity (≥3 births: OR = 0.38, 95% CI = 0.28-0.54), and Black women had the largest ORs for family history (OR = 1.77, 95% CI = 1.42-2.21) and endometriosis (OR = 2.42, 95% CI = 1.65-3.55). Conclusions:Although racial/ethnic heterogeneity was observed for hysterectomy, our findings support the validity of EOC risk factors across all racial/ethnic groups, and further suggest that any racial/ethnic population with a higher prevalence of a modifiable risk factor should be targeted to disseminate information about prevention.

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