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Different Risk Factor Profiles for Mucinous and Nonmucinous Ovarian Cancer: Results from the Danish MALOVA Study

¹ Institute of Cancer Epidemiology, Danish Cancer Society; ² Department of Pathology, Bispebjerg Hospital; ³ The Gynaecologic Clinic, The Juliane Marie Centre, Rigshospitalet, Copenhagen, Denmark; and ⁴ Department of Gynaecology and Obstetrics, Aarhus University Hospital, Skejby, Aarhus, Denmark

Requests for reprints: Susanne Krüger Kjaer, Institute of Cancer Epidemiology, Danish Cancer Society/Rigshospitalet, Strandboulevarden 49, DK-2100 Copenhagen, Denmark. Phone: 45-3525-7663. E-mail: susanne{at}cancer.dk.

Objectives: The aim of the study was to examine the overall risk factors for epithelial ovarian cancer and according to histologic subtypes.

Materials and Methods: Ovarian cancer cases and controls were recruited from 1995 to 1999, and personal interviews were conducted. A total of 554 cases and 1,564 randomly selected controls were included. The analyses were done using multiple logistic regression models.

Results: The overall risk of ovarian cancer decreased with ever being pregnant [odds ratios (OR), 0.40; 95% confidence intervals (CI), 0.30-0.55], with increasing pregnancies (OR, 0.63; 95% CI, 0.45-0.87 and OR, 0.51; 95% CI, 0.37-0.69 for two and three pregnancies as compared with one), and with older age at first and last pregnancy, respectively. Increasing years of ovulation was a very strong risk factor with a 7% to 8% increase in risk for each year of ovulation. Use of oral contraceptives (OR, 0.67, 95% CI, 0.53-0.85) and longer duration of use were associated with a decreased risk of ovarian cancer. Ever use of hormone replacement therapy increased the overall risk (OR, 1.30; 95% CI, 1.05-1.61). For all those variables, the effect was present for serous tumors, endometrioid tumors, and tumors of other histologies, but not for mucinous tumors. In contrast, current smoking was a risk factor only for mucinous tumors (OR, 1.78; 95% CI, 1.01-3.15) and increasing body mass index tended to increase the risk especially for mucinous and endometrioid tumors.

Conclusions: We confirmed already known risk factors for ovarian cancer, and we observed significant differences in the risk profiles between mucinous and nonmucinous tumors indicating different etiologies. (Cancer Epidemiol Biomarkers Prev 2007;16(6):1160–6)

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