Table 2.
Adjusted RR and 95% CI for ovarian cancer in relation to hormonal and reproductive factors in the NIH-AARP Diet and Health Study, 1995-2006
| Histological Subtypes | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Non-cases | All Epithelial (N=849) | Serous (N=451) | Endometrioid (N=78) | Mucinous (N=38) | Clear Cell (N=27) | Other (N=255) | |||||||||||||
| N | N | RR | 95% CI | N | RR | 95% CI | N | RR | 95% CI | N | RR | 95% CI | N | RR | 95% CI | N | RR | 95% CI | |
| Age at menarche (years) | |||||||||||||||||||
| < 13 | 81,348 | 406 | 1(ref) | 228 | 1(ref) | 38 | 1(ref) | 17 | 1(ref) | 11 | 1(ref) | 112 | 1(ref) | ||||||
| 13-14 | 70,564 | 363 | 1.00 | (0.88-1.16) | 181 | 0.90 | (0.74-1.09) | 34 | 1.05 | (0.66-1.66) | 17 | 1.12 | (0.57-2.20) | 14 | 1.53 | (0.69-3.37) | 117 | 1.15 | (0.89-1.50) |
| ≥ 15 | 16,071 | 77 | 0.94 | (0.74-1.20) | 42 | 0.92 | (0.66-1.28) | 5 | 0.69 | (0.27-1.75) | 4 | 1.14 | (0.38-3.38) | 2 | 1.00 | (0.22-4.53) | 24 | 1.03 | (0.67-1.61) |
| Pheterogenity= | 0.67 | ||||||||||||||||||
| Age at menopause | |||||||||||||||||||
| < 45 | 13,847 | 56 | 1(ref) | 34 | 1(ref) | 2 | 1(ref) | 2 | 1(ref) | 1 | 1(ref) | 17 | 1(ref) | ||||||
| 45-49 | 32,073 | 158 | 1.01 | (0.83-1.24) | 81 | 0.93 | (0.71-1.22) | 13 | 0.90 | (0.46-1.77) | 12 | 2.10 | (0.85-5.19) | 8 | 2.01 | (0.69-5.87) | 44 | 1.00 | (0.69-1.46) |
| 50-54 | 55,559 | 293 | 1.07 | (0.91-1.27) | 144 | 0.94 | (0.74-1.18) | 29 | 1.16 | (0.67-1.99) | 15 | 1.58 | (0.66-3.75) | 9 | 1.39 | (0.49-3.94) | 96 | 1.24 | (0.92-1.68) |
| ≥ 55 | 12,516 | 67 | 1.04 | (0.79-1.36) | 35 | 0.95 | (0.66-1.37) | 7 | 1.31 | (0.56-3.04) | 3 | 1.35 | (0.36-5.11) | 0 | 22 | 1.17 | (0.73-1.88) | ||
| Pheterogenity= | 0.29 | ||||||||||||||||||
| Menopausal hormone | |||||||||||||||||||
| Never user | 91,716 | 420 | 1(ref) | 209 | 1(ref) | 34 | 1(ref) | 29 | 1(ref) | 14 | 1(ref) | 134 | 1(ref) | ||||||
| Ever user | 76,826 | 429 | 1.33 | (1.16-1.53) | 242 | 1.50 | (1.24-1.81) | 44 | 1.57 | (0.99-2.47) | 9 | 0.37 | (0.18-0.80) | 13 | 1.06 | (0.49-2.29) | 121 | 1.25 | (0.98-1.61) |
| Pheterogenity= | 0.01 | ||||||||||||||||||
| Duration of MHT use | |||||||||||||||||||
| Never user | 91,716 | 420 | 1(ref) | 209 | 1(ref) | 34 | 1(ref) | 29 | 1(ref) | 14 | 1(ref) | 134 | 1(ref) | ||||||
| <5 years | 33,286 | 139 | 1.03 | 0.85, 1.25 | 82 | 1.21 | 0.93, 1.56 | 15 | 1.18 | 0.63, 2.19 | 2 | 0.22 | 0.05, 0.92 | 3 | 0.47 | 0.13, 1.67 | 37 | 0.96 | 0.66, 1.39 |
| 5-9 years | 21,061 | 132 | 1.51 | 1.24, 1.84 | 78 | 1.78 | 1.36, 2.32 | 12 | 1.49 | 0.76, 2.90 | 3 | 0.45 | 0.13, 1.49 | 5 | 1.52 | 0.54, 4.30 | 34 | 1.34 | 0.92, 1.97 |
| ≥10 years | 22,260 | 158 | 1.57 | 1.31, 1.89 | 82 | 1.64 | 1.27, 2.13 | 17 | 2.27 | 1.26, 4.09 | 4 | 0.50 | 0.17, 1.42 | 5 | 1.82 | 0.64, 5.17 | 50 | 1.53 | 1.11, 2.13 |
| Pheterogenity= | 0.06 | ||||||||||||||||||
| Oral contraceptive use | |||||||||||||||||||
| Never user | 99,727 | 577 | 1(ref) | 309 | 1(ref) | 51 | 1(ref) | 22 | 1(ref) | 13 | 1(ref) | 182 | 1(ref) | ||||||
| Ever user | 67,605 | 265 | 0.74 | 0.63, 0.87 | 140 | 0.69 | 0.55, 0.85 | 27 | 0.69 | 0.42, 1.14 | 16 | 1.72 | 0.86, 3.42 | 14 | 1.47 | 0.64, 3.40 | 68 | 0.70 | 0.52, 0.94 |
| Pheterogenity= | 0.03 | ||||||||||||||||||
| Duration of oral contraceptive use | |||||||||||||||||||
| Never user | 99,727 | 577 | 1(ref) | 309 | 1(ref) | 51 | 1(ref) | 22 | 1(ref) | 13 | 1(ref) | 182 | 1(ref) | ||||||
| 1-4 years | 29,975 | 128 | 0.82 | 0.67, 1.00 | 66 | 0.75 | 0.57, 0.98 | 12 | 0.72 | 0.38, 1.38 | 7 | 1.65 | 0.68, 4.00 | 9 | 2.19 | 0.87, 5.50 | 34 | 0.79 | 0.54, 1.15 |
| 5-9 years | 21,205 | 87 | 0.78 | 0.62, 0.98 | 48 | 0.75 | 0.55, 1.03 | 10 | 0.83 | 0.41, 1.67 | 4 | 1.42 | 0.48, 4.26 | 4 | 1.36 | 0.42, 4.43 | 21 | 0.68 | 0.43, 1.09 |
| ≥10 years | 16,425 | 50 | 0.56 | 0.42, 0.75 | 26 | 0.51 | 0.34, 0.77 | 5 | 0.52 | 0.20, 1.32 | 5 | 2.30 | 0.84, 6.27 | 1 | 0.43 | 0.05, 3.36 | 13 | 0.52 | 0.29, 0.92 |
| Pheterogenity= | 0.13 | ||||||||||||||||||
| Parous | |||||||||||||||||||
| Nulliparous | 25,785 | 170 | 1(ref) | 82 | 1(ref) | 22 | 1(ref) | 8 | 1(ref) | 11 | 1(ref) | 47 | 1(ref) | ||||||
| Parous | 142,092 | 676 | 0.71 | 0.61, 0.85 | 369 | 0.83 | 0.65, 1.06 | 56 | 0.49 | 0.30, 0.80 | 29 | 0.54 | 0.25, 1.14 | 16 | 0.28 | 0.13, 0.62 | 206 | 0.76 | 0.56, 1.04 |
| Pheterogenity= | 0.05 | ||||||||||||||||||
| Age at first birth (years) | |||||||||||||||||||
| Nulliparous | 25,785 | 170 | 1ref | 82 | 1(ref) | 22 | 1(ref) | 8 | 1(ref) | 11 | 1(ref) | 47 | 1(ref) | ||||||
| <20 | 27,790 | 122 | 0.70 | 0.50, 0.98 | 60 | 0.69 | 0.50, 0.97 | 12 | 0.51 | 0.25, 1.04 | 3 | 0.34 | 0.09, 1.29 | 3 | 0.26 | 0.07, 0.94 | 44 | 0.92 | 0.61, 1.39 |
| 20-<25 | 72,486 | 338 | 0.81 | 0.62, 1.05 | 187 | 0.80 | 0.61, 1.03 | 28 | 0.47 | 0.27, 0.83 | 17 | 0.68 | 0.29, 1.59 | 4 | 0.14 | 0.04, 0.44 | 102 | 0.74 | 0.52, 1.05 |
| 25-<30 | 31,133 | 158 | 0.98 | 0.67, 1.22 | 90 | 0.89 | 0.66, 1.20 | 7 | 0.28 | 0.12, 0.65 | 8 | 0.73 | 0.27, 1.96 | 7 | 0.54 | 0.21, 1.43 | 46 | 0.75 | 0.50, 1.13 |
| >30 | 10,644 | 58 | 0.89 | 0.59, 1.35 | 30 | 0.88 | 0.58, 1.34 | 9 | 1.06 | 0.49, 2.32 | 2 | 0.52 | 0.11, 2.46 | 2 | 0.45 | 0.10, 2.03 | 15 | 0.72 | 0.40, 1.29 |
| Pheterogenity= | 0.36 | ||||||||||||||||||
| Parity (births) | |||||||||||||||||||
| Nulliparous | 25,785 | 170 | 1ref | 82 | 1(ref) | 22 | 1(ref) | 8 | 1(ref) | 11 | 1(ref) | 47 | 1(ref) | ||||||
| 1 | 17,398 | 104 | 0.93 | 0.73, 1.19 | 55 | 1.02 | 0.73, 1.44 | 11 | 0.77 | 0.37, 1.59 | 6 | 1.06 | 0.37, 3.09 | 4 | 0.51 | 0.16, 1.61 | 28 | 0.91 | 0.57, 1.46 |
| 2 | 43,696 | 216 | 0.76 | 0.62, 0.93 | 119 | 0.87 | 0.65, 1.15 | 20 | 0.54 | 0.29, 1.00 | 10 | 0.73 | 0.28, 1.80 | 5 | 0.26 | 0.09, 0.74 | 62 | 0.79 | 0.54, 1.16 |
| ≥ 3 | 81,018 | 356 | 0.64 | 0.53, 0.77 | 195 | 0.74 | 0.57, 0.96 | 25 | 0.38 | 0.21, 0.67 | 13 | 0.44 | 0.18, 1.07 | 7 | 0.23 | 0.09, 0.60 | 116 | 0.72 | 0.51, 1.02 |
| Pheterogenity= | 0.03 | ||||||||||||||||||
† Adjusted for age (continuous), oral contraceptive use (ever/never), parity (yes/no), menopausal hormone therapy (ever/never). Unknow n/missing set as a separate category within each factor. For duration of oral contraceptive and menopausal hormone therapy use, excluded dichotomous ever/never use variable accordingly, as done for parous for categories of parity.
‡ P value from polytomous logistic regression of case-only analysis comparing each covariate, adjusted for factors listed above.