Table 4.
Associations (HR and 95% CI)a between hormone-related factors and EOC risk by race/ethnicity.
| Overallb | White | African American | Native Hawaiian | Japanese American | Latina | Pintc | |
|---|---|---|---|---|---|---|---|
| Number of cases/total number | 607/91,625 | 155/21,742 | 93/17,870 | 57/6,789 | 161/25,028 | 141/20,196 | |
| Parity | |||||||
| Nulliparous (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Parous | 0.72 (0.58, 0.89) | 0.70 (0.47, 1.03) | 0.82 (0.46, 1.45) | 0.77 (0.33, 1.84) | 0.64 (0.43, 0.94) | 0.82 (0.47, 1.44) | 0.89d |
| 1 child | 0.82 (0.61, 1.12) | 1.01 (0.60, 1.71) | 0.54 (0.23, 1.25) | 0.43 (0.09, 2.16) | 0.85 (0.49, 1.46) | 0.96 (0.43, 2.11) | |
| 2 children | 0.78 (0.60, 1.01) | 0.67 (0.41, 1.07) | 0.93 (0.46, 1.84) | 0.84 (0.29, 2.39) | 0.72 (0.46, 1.12) | 1.00 (0.51, 1.96) | |
| 3 children | 0.74 (0.56, 0.97) | 0.55 (0.33, 0.94) | 1.20 (0.61, 2.36) | 0.83 (0.30, 2.27) | 0.59 (0.36, 0.96) | 1.00 (0.53, 1.91) | |
| ≥4 children | 0.62 (0.48, 0.81) | 0.69 (0.43, 1.12) | 0.66 (0.34, 1.27) | 0.80 (0.32, 1.96) | 0.45 (0.26, 0.79) | 0.71 (0.40, 1.28) | 0.43e |
| ptrend number of children (incl. 0) | <0.01 | 0.08 | 0.64 | 0.78 | <0.01 | 0.02 | |
| ptrend number of children (excl. 0) | 0.01 | 0.34 | 0.92 | 0.49 | 0.03 | 0.01 | |
| Age at menarche | |||||||
| <13 years (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| 13-14 years | 0.83 (0.70, 0.99) | 0.98 (0.70, 1.39) | 0.72 (0.45, 1.15) | 0.86 (0.48, 1.55) | 0.74 (0.52, 1.05) | 0.84 (0.59, 1.21) | |
| ≥15 years | 1.01 (0.79, 1.29) | 1.50 (0.95, 2.39) | 0.81 (0.42, 1.56) | 0.92 (0.39, 2.21) | 0.98 (0.62, 1.55) | 0.80 (0.48, 1.35) | 0.89 |
| Age at natural menopausef | |||||||
| <45 years (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| 45-49 years | 1.04 (0.75, 1.44) | 0.96 (0.52, 1.76) | 1.56 (0.60, 4.03) | 0.72 (0.22, 2.36) | 0.91 (0.47, 1.74) | 1.03 (0.53, 1.99) | |
| 50-54 years | 1.10 (0.80, 1.51) | 0.83 (0.46, 1.52) | 1.88 (0.75, 4.69) | 1.66 (0.61, 4.56) | 0.84 (0.45, 1.55) | 1.16 (0.61, 2.20) | |
| ≥55 years | 1.25 (0.84, 1.86) | 1.00 (0.47, 2.16) | 0.76 (0.19, 3.09) | 0.67 (0.13, 3.54) | 0.99 (0.47, 2.07) | 2.60 (1.24, 5.42) | 0.18 |
| Cumulative ovulatory yearsg | |||||||
| Tertile 1 (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Tertile 2 | 1.06 (0.81, 1.38) | 1.18 (0.72, 1.94) | 1.04 (0.48, 2.23) | 2.14 (0.84, 5.46) | 0.74 (0.44, 1.23) | 0.98 (0.55, 1.74) | |
| Tertile 3 | 1.27 (0.96, 1.67) | 1.25 (0.73, 2.13) | 1.39 (0.63, 3.04) | 2.57 (0.95, 6.96) | 0.80 (0.48, 1.33) | 1.64 (0.93, 2.91) | 0.37 |
| Ptrend | 0.01 | 0.25 | 0.31 | 0.09 | 0.64 | 0.08 | |
| OC use | |||||||
| Never (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Ever | 0.77 (0.63, 0.94) | 1.13 (0.78, 1.66) | 0.77 (0.46, 1.30) | 0.62 (0.33, 1.17) | 0.60 (0.39, 0.93) | 0.69 (0.46, 1.04) | 0.67h |
| Ever <5 years | 0.91 (0.73, 1.13) | 1.43 (0.96, 2.14) | 0.88 (0.49, 1.56) | 0.76 (0.39, 1.50) | 0.75 (0.47, 1.18) | 0.71 (0.45, 1.13) | |
| Ever ≥5 years | 0.54 (0.39, 0.73) | 0.66 (0.38, 1.14) | 0.66 (0.32, 1.35) | 0.38 (0.13, 1.11) | 0.35 (0.16, 0.78) | 0.65 (0.34, 1.25) | 0.63i |
| PMH usej | |||||||
| Never (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Ever | 1.08 (0.91, 1.29) | 0.92 (0.65, 1.31) | 0.82 (0.51, 1.30) | 0.92 (0.50, 1.69) | 1.21 (0.86, 1.70) | 1.46 (1.02, 2.10) | 0.25h |
| Ever <5 years | 1.05 (0.86, 1.29) | 0.82 (0.54, 1.26) | 0.85 (0.51, 1.42) | 0.97 (0.50, 1.87) | 1.30 (0.88, 1.91) | 1.31 (0.87, 1.98) | |
| Ever ≥5 years | 1.16 (0.91, 1.48) | 1.04 (0.68, 1.59) | 0.59 (0.24, 1.48) | 0.83 (0.29, 2.40) | 1.11 (0.70, 1.76) | 2.13 (1.30, 3.49) | 0.18i |
| Hysterectomyk | |||||||
| No (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Yes | 1.02 (0.83, 1.25) | 1.09 (0.73, 1.62) | 1.16 (0.74, 1.83) | 1.13 (0.60, 2.13) | 0.77 (0.48, 1.24) | 1.00 (0.67, 1.52) | 0.73 |
| BMI | |||||||
| <25 kg/m2 (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| 25-29.9 kg/m2 | 0.77 (0.63, 0.94) | 0.83 (0.56, 1.21) | 0.81 (0.46, 1.43) | 0.48 (0.24, 0.95) | 0.87 (0.59, 1.27) | 0.75 (0.50, 1.13) | |
| ≥30 kg/m2 | 1.12 (0.90, 1.39) | 1.12 (0.74, 1.70) | 1.37 (0.81, 2.29) | 0.76 (0.42, 1.40) | 1.03 (0.54, 1.97) | 1.10 (0.73, 1.66) | 0.94 |
| ptrend | 0.16 | 0.23 | 0.52 | 0.64 | 0.82 | 0.40 | |
| Diabetes | |||||||
| No (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Yes | 1.12 (0.86, 1.45) | 0.98 (0.46, 2.10) | 1.38 (0.80, 2.39) | 1.70 (0.87, 3.30) | 0.72 (0.38, 1.36) | 1.16 (0.72, 1.85) | 0.40 |
| Smoking status | |||||||
| Never (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Ever | 1.07 (0.90,1.26) | 1.08 (0.79, 1.49) | 0.86 (0.57, 1.30) | 0.77 (0.45, 1.29) | 1.20 (0.86, 1.68) | 1.25 (0.88, 1.77) | 0.42 |
| Family history of breast and/or ovarian cancer | |||||||
| No (ref.) | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | 1.00 | |
| Yes | 1.19 (0.96, 1.48) | 1.08 (0.71, 1.65) | 1.08 (0.62, 1.90) | 0.82 (0.38, 1.73) | 1.36 (0.90, 2.05) | 1.48 (0.95, 2.31) | 0.63 |
Cox proportional hazards models adjusted for baseline age (continuous), menopausal status (pre-/peri- [ref.], postmenopausal), use of OCs (never [ref.], ever), and number of children (0 [ref.], 1, 2, 3, ≥4)
Models in the full cohort additionally adjusted for race/ethnicity (White [ref.], African American, Native Hawaiian, Japanese American, Latina)
Pinteraction comparing models without to models with interaction terms for the exposure and race/ethnicity variables using log-likelihood ratio tests
parity (no, yes)
number of children (0, 1, 2, 3, =>4)
among 51,164 postmenopausal women with a natural menopause
among 63,107 women with available information
never vs ever use
duration of use (never, <5, ≥5 years)
among 75,768 postmenopausal women
additionally adjusted for ever PMH use (if postmenopausal; never [ref], ever). Abbreviations: 95% CI: 95% confidence interval, BMI: body mass index, EOC: epithelial ovarian cancer; HR: hazard ratio, OC: oral contraceptive, PMH: postmenopausal hormone therapy.