Table 4.
Multivariable ORsa (95% CI) for associations between exposures and high grade serous tubo-ovarian carcinomab risk by racial and ethnic group
| Exposure |
Asian
c
OR (95% CI) |
Native Hawaiian/Pacific Islander c OR (95% CI) |
Hispanic
OR (95% CI) |
White, non-Hispanic
OR (95% CI) |
P for heterogeneity d |
|---|---|---|---|---|---|
| Age at menarche, y | |||||
| <12 | 1.00 | 1.00 | 1.00 | 1.00 | .48 |
| 12-13 | 1.25 (0.87-1.81) | 1.85 (0.79-4.35) | 1.11 (0.78-1.59) | 1.01 (0.93-1.10) | |
| ≥14 | 1.28 (0.86-1.89) | 2.19 (0.82-5.82) | 1.07 (0.71-1.60) | 0.94 (0.85-1.03) | |
| P for trende | 0.23 | 0.10 | 0.69 | 0.23 | .14 |
| OC use | |||||
| Never | 1.00 | 1.00 | 1.00 | 1.00 | .08 |
| <5 y | 0.54 (0.39-0.74) | 0.29 (0.12-0.73) | 0.90 (0.65-1.27) | 0.78 (0.72-0.84) | |
| ≥5 y | 0.35 (0.26-0.55) | 0.44 (0.14-1.34) | 0.55 (0.37-0.83) | 0.48 (0.44-0.52) | |
| P for trende | <0.0001 | 0.07 | 0.01 | <0.0001 | .25 |
| Parity | |||||
| 0 live births | 1.00 | 1.00 | 1.00 | 1.00 | .14 |
| 1 | 0.52 (0.34-0.82) | 0.42 (0.09-1.95) | 0.96 (0.56-1.66) | 0.82 (0.73-0.91) | |
| 2 | 0.42 (0.28-0.61) | 0.44 (0.12-1.67) | 0.80 (0.49-1.31) | 0.69 (0.63-0.76) | |
| ≥3 | 0.44 (0.30-0.64) | 0.18 (0.05-0.58) | 0.68 (0.44-1.05) | 0.63 (0.58-0.69) | |
| P for trende | <0.0001 | <0.01 | 0.04 | <0.0001 | .05 |
| Tubal ligation | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .06 |
| Yes | 0.76 (0.53-1.08) | 0.28 (0.12-0.63) | 0.84 (0.59-1.20) | 0.85 (0.78-0.93) | |
| Breastfeedingf | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .55 |
| Yes | 0.78 (0.55-1.12) | 0.59 (0.27-1.31) | 0.98 (0.67-1.43) | 0.75 (0.69-0.82) | |
| Postmenopausal hormone useg | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .60 |
| Yes | 0.84 (0.60-1.19) | 0.65 (0.26-1.61) | 0.97 (0.66-1.42) | 1.01 (0.94-1.08) | |
| Endometriosis | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .38 |
| Yes | 1.84 (1.13-3.00) | 1.07 (0.21-5.39) | 1.23 (0.60-2.52) | 1.17 (1.04-1.33) | |
| Hysterectomyh | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .98 |
| Yes | 1.21 (0.77-1.89) | 1.27 (0.45-3.55) | 1.30 (0.86-1.98) | 1.81 (1.08-1.29) | |
| BMI, recenti | |||||
| <18.5 | 1.03 (0.46-2.29) | 1.27 (0.13-12.8) | 0.91 (0.71-1.17) | ||
| 18.5-24.9 | 1.00 | 1.00 | 1.00 | 1.00 | .95 |
| 25.0-29.9 | 0.97 (0.68-1.38) | 1.07 (0.44-2.56) | 0.89 (0.61-1.27) | 0.96 (0.89-1.04) | |
| 30.0-34.9 | 1.42 (0.75-2.70) | 0.87 (0.31-2.41) | 1.02 (0.64-1.64) | 1.02 (0.92-1.14) | |
| ≥35.0 | 2.33 (0.79-6.81) | 0.58 (0.21-1.64) | 0.94 (0.57-1.55) | 1.04 (0.92-1.18) | |
| P for trende | 0.26 | 0.35 | 0.85 | 0.60 | .55 |
| ≥30.0 (vs 18.5-24.9) | 1.60 (0.91-2.81) | 0.71 (0.30-1.65) | 0.98 (0.67-1.45) | 1.03 (0.94-1.12) | .37 |
| BMI, at age 18 y | |||||
| <18.5 | 1.13 (0.78-1.64) | 1.73 (0.44-6.75) | 0.89 (0.56-1.43) | 0.96 (0.87-1.06) | |
| 18.5-24.9 | 1.00 | 1.00 | 1.00 | 1.00 | .39 |
| 25.0-29.9 | 0.66 (0.30-1.49) | 0.54 (0.19-1.55) | 0.97 (0.57-1.65) | 1.20 (1.03-1.39) | |
| ≥30.0 | 1.67 (0.35-7.92) | 0.47 (0.10-2.24) | 1.68 (0.66-4.24) | 0.96 (0.87-1.06) | |
| P for trende | 0.39 | 0.09 | 0.45 | 0.09 | .21 |
| Smoking | |||||
| Never | 1.00 | 1.00 | 1.00 | 1.00 | .07 |
| Former | 0.83 (0.57-1.21) | 1.16 (0.52-2.62) | 1.07 (0.74-1.56) | 1.03 (0.96-1.11) | |
| Current | 0.45 (0.23-0.86) | 0.68 (0.26-1.79) | 1.30 (0.75-2.26) | 1.24 (1.12-1.37) | |
| Family history of breast cancer | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .18 |
| Yes | 1.02 (0.69-1.68) | 1.01 (0.31-3.37) | 2.10 (1.30-3.40) | 1.33 (1.22-1.45) | |
| Family history of ovarian cancer | |||||
| No | 1.00 | 1.00 | 1.00 | 1.00 | .45 |
| Yes | 1.61 (0.75-3.44) | 2.03 (1.08-3.81) | 2.76 (2.37-3.21) |
Abbreviations: BMI, body mass index; OC, oral contraceptive; OR, odds ratio.
a All models included study site, age group, and racial and ethnic group as strata variables; the exposure variable; and interaction terms for racial and ethnic group and the exposure variable. OC use (never [reference], < 5 y, ≥ 5 y) and parity (0 [reference], 1, 2, ≥3 live births) were also included as adjustment variables.
b High-grade serous tubo-ovarian carcinoma includes serous histology grades 2-4; serous histology with missing/unknown grade; endometrioid histology grade 3-4; and poorly differentiated epithelial histology grades 2-4.
c Asian includes Chinese, Japanese, Korean, Filipino, Vietnamese, Thai. Native Hawaiian/Pacific Islander includes Hawaiian, Pacific Islander (Tongan, Samoan, Māori, Palauan, Chuukese, Micronesian).
d P value for heterogeneity was calculated using the global Wald test on the interaction terms (race and ethnicity and categorical exposure variable(s), or race and ethnicity, and trend exposure variable).
e P for trend calculated using the median for that category: age at menarche (10, 12.5, 14 y); OC use (0, 2.5, 5 y); parity (0, 1, 2, 3 live births); recent BMI (18.5, 21.7, 27.5, 32.5, 35); BMI at age 18 y (18.5, 21.7, 27.5, 30.0).
f Breastfeeding among parous women only.
g Postmenopausal hormone use refers to use of estrogen only, estrogen plus progesterone, and unknown formulation types among postmenopausal women only.
h Hysterectomy analysis excludes 1 study outlier (Mayo Clinic Ovarian Cancer Case-Control Study).
i Recent BMI refers to 1 y before the reference date for all sites, except for Diseases of the Ovary and their Evaluation Study and Hawaii Ovarian Cancer Case-Control Study (5 y before reference date). BMI calculated as weight (kg) divided by height (m2).