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. 2017 Feb 16;116(7):964–971. doi: 10.1038/bjc.2017.35

Table 2. Association between reproductive and hormonal exposures and ovarian cancer-specific survival.

  OC deaths/na HR model 1b 95% CI P-value OC deaths/nc HR model 2d 95% CI P-value
Age at diagnosis 638/1394 1.25 1.17, 1.35 <0.0001 404/833 1.19 1.09, 1.31 0.0002
Histology                
 Serous 439/758 1.00 Ref. Ref. 280/468 1.00 Ref. Ref.
 Mucinous 25/115 0.50 0.33, 0.76 0.001 20/67 1.26 0.90, 1.76 0.18
 Endometrioid 80/298 0.58 0.45, 0.75 <0.0001 45/164 1.16 0.66, 2.01 0.61
 Clear cell 24/94 0.62 0.41, 0.95 0.03 17/50 0.85 0.55, 1.32 0.48
 Other 70/129 0.87 0.67, 1.12 0.27 42/84 1.34 0.75, 2.40 0.33
Stage                
 I 29/254 1.00 Ref. Ref. 18/173 1.00 Ref. Ref.
 II 82/247 2.82 1.84, 4.33 <0.0001 59/142 4.09 2.37, 7.04 <0.0001
 III 402/699 6.38 4.28, 9.51 <0.0001 288/455 8.73 5.18, 14.72 <0.0001
 IV 125/194 9.17 5.95, 14.13 <0.0001 39/63 11.44 6.23, 21.02 <0.0001
Tumour characteristics                
 Residual disease                
  No 92/300 1.00 Ref. Ref. 92/300 1.00 Ref. Ref.
  Yes 312/533 1.64 1.28, 2.11 0.0001 312/533 1.64 1.28, 2.11 0.0001
Reproductive/hormonal factors                
 Age at menarche (years), continuous 585/1297 1.02 0.96, 1.07 0.58 369/762 1.04 0.97, 1.11 0.30
 Age at menarche (years)                
  ⩽12 219/489 1.00 Ref. Ref. 146/301 1.00 Ref. Ref.
  13 179/409 0.97 0.79, 1.18 0.74 109/231 1.00 0.77, 1.29 0.98
  14 100/221 0.91 0.72, 1.16 0.44 60/123 1.03 0.76, 1.39 0.87
  >14 87/178 1.10 0.85, 1.41 0.47 54/107 1.13 0.83, 1.56 0.44
 Parity, continuouse 465/1037 1.04 0.97, 1.11 0.26 289/611 1.04 0.95, 1.13 0.41
 Paritye                
  1 73/190 1.00 Ref. Ref. 52/111 1.00 Ref. Ref.
  2 178/407 1.19 0.90, 1.56 0.22 108/244 0.92 0.66, 1.28 0.61
  >3 214/440 1.13 0.86, 1.49 0.37 129/256 0.96 0.69, 1.34 0.82
 Parity, never/ever                
  Nulliparous 99/218 1.00 Ref. Ref. 64/126 1.00 Ref. Ref.
  Parous 487/1084 0.82 0.66, 1.02 0.07 305/638 0.71 0.54, 0.93 0.01
 Age at first birth (years), continuouse 408/909 1.00 0.98, 1.02 0.94 250/520 1.01 0.98, 1.03 0.70
 Age at first birthe                
  <20 54/117 1.00 Ref. Ref. 33/68 1.00 Ref. Ref.
  20–30 306/685 0.90 0.67, 1.20 0.45 187/387 0.96 0.66, 1.40 0.84
  >30 48/107 0.99 0.67, 1.46 0.94 30/65 1.02 0.62, 1.68 0.94
 Breastfede                
  Never 197/434 1.00 Ref. Ref. 124/256 1.00 Ref. Ref.
  Ever 268/603 1.07 0.89, 1.28 0.49 165/355 0.96 0.76, 1.21 0.71
 Duration of breastfeeding (months), continuouse 465/1037 1.00 1.00, 1.01 0.50 285/605 1.01 1.00, 1.01 0.27
 Duration of breastfeeding (months)e                
  0 192/427 1.00 Ref. Ref. 121/252 1.00 Ref. Ref.
  1–6 122/286 1.03 0.82, 1.30 0.78 82/180 0.91 0.68, 1.20 0.50
  >6 144/313 1.11 0.90, 1.38 0.34 82/173 1.04 0.79, 1.38 0.77
 Oral contraceptive use                
  Never 284/568 1.00 Ref. Ref. 167/328 1.00 Ref. Ref.
  Ever 302/732 1.00 0.83, 1.20 0.99 203/437 1.16 0.92, 1.47 0.20
 Duration of oral contraceptive use (years), continuous 482/1096 1.00 0.98, 1.02 0.99 308/648 1.02 0.99, 1.04 0.27
 Duration of oral contraceptive use (years)                
  0 268/570 1.00 Ref. Ref. 164/336 1.00 Ref. Ref.
  1–5 119/307 1.00 0.80, 1.25 0.98 79/185 1.06 0.81, 1.41 0.66
  >5 96/219 1.08 0.84, 1.38 0.55 65/127 1.23 0.91, 1.67 0.18
 Oestrogen HRT                
  Never 424/977 1.00 Ref. Ref. 280/577 1.00 Ref. Ref.
  Ever 160/322 0.90 0.75, 1.09 0.28 89/187 0.79 0.62, 1.01 0.06
 Tamoxifen use                
  Never 164/414 1.00 Ref. Ref. 82/183 1.00 Ref. Ref.
  Ever 3/7 2.54 0.77, 8.38 0.13 3/4 3.57 0.99, 12.93 0.05
 Fertility treatment                
  Never 570/1258 1.00 Ref. Ref. 359/741 1.00 Ref. Ref.
  Ever 16/38 0.89 0.54, 1.47 0.64 11/20 1.24 0.67, 2.29 0.50
 Endometriosis                
  No 551/1219 1.00 Ref. Ref. 349/716 1.00 Ref. Ref.
  Yes 31/70 1.27 0.88, 1.83 0.21 17/38 1.10 0.67, 1.81 0.71
 Age at natural menopause (years), continuous 341/692 0.98 0.96, 1.01 0.11 208/403 0.98 0.94, 1.01 0.14
 Age at natural menopause                
  ⩽47 97/175 1.00 Ref. Ref. 55/99 1.00 Ref. Ref.
  >47–50 118/228 0.89 0.68, 1.17 0.41 78/138 0.94 0.66, 1.34 0.74
  >50–52 61/147 0.78 0.56, 1.07 0.12 36/87 0.74 0.48, 1.14 0.17
  >52 65/142 0.75 0.55, 1.03 0.08 39/79 0.69 0.45, 1.05 0.08
 Menopausal status at diagnosis                
  Premenopausal 131/370 1.00 Ref. Ref. 89/211 1.00 Ref. Ref.
  Postmenopausal 449/907 1.01 0.77, 1.32 0.97 278/542 0.96 0.69, 1.35 0.83
 IUD use                
  Never 487/1090 1.00 Ref. Ref. 306/638 1.00 Ref. Ref.
  Ever 98/206 1.09 0.87, 1.36 0.45 63/122 1.06 0.80, 1.40 0.71
 Tubal ligation                
  Never 438/998 1.00 Ref. Ref. 276/581 1.00 Ref. Ref.
  Ever 148/302 1.08 0.89, 1.31 0.43 94/183 0.98 0.77, 1.25 0.87
 Number of ovulatory cycles                
  ⩽322.28 95/228 1.00 Ref. Ref. 61/130 1.00 Ref. Ref.
  >322.28–389.52 105/230 0.87 0.65, 1.16 0.35 65/134 0.82 0.58, 1.18 0.29
  >389.52–439.42 101/225 0.78 0.58, 1.05 0.10 62/133 0.74 0.50, 1.08 0.12
  >439.42 102/225 0.82 0.60, 1.11 0.20 65/143 0.63 0.43, 0.94 0.02

Abbreviations: CI=confidence interval; HR=hazard ratio; HRT = hormone replacement therapy; IUD=intrauterine device; OC=ovarian cancer; ref.=reference value.

a

There were a total of n=1394 in model 1 because 27 participants had missing information on tumour stage.

b

Adjusted for age at diagnosis (continuous), histology (serous, mucinous, endometrioid, clear cell, other), and stage (I, II, III, IV).

c

There were a total of n=833 in model 2 because 588 participants had missing information on residual disease after debulking surgery.

d

Adjusted for model 1 and residual disease (no residual disease, any residual disease).

e

Among parous women only.