Ovarian cancer risk factors by histologic subtypes in the NIH-AARP diet and health study

Hannah P. Yang, Britton Trabert, Megan A. Murphy, Mark E. Sherman, Joshua N. Sampson, Louise A. Brinton, Patricia Hartge, Albert Hollenbeck, Yikyung Park, Nicolas Wentzensen

Research output: Contribution to journalArticlepeer-review

73 Scopus citations


Data suggest that risk factors for ovarian carcinoma vary by histologic type, but findings are inconsistent. We prospectively evaluated risk factors by histological subtypes of incident ovarian cancer (n = 849) in a cohort of 169,391 women in the NIH-AARP Diet and Health Study. We constructed Cox models of individual exposures by comparing case subtypes to the entire non-case group and assessed p-heterogeneity in case-case comparisons using serous as the reference category. Substantial risk differences between histologic subtypes were observed for menopausal hormone therapy (MHT) use, oral contraceptive (OC) use, parity and body mass index (p-heterogeneity = 0.01, 0.03, 0.05, 0.03, respectively). MHT users were at increased risk for all histologic subtypes except for mucinous carcinomas, where risk was reduced (relative risk (RR) = 0.37; 95% confidence interval (CI): 0.18, 0.80). OC users were only at significantly decreased risk for serous cancers (RR = 0.69; 95% CI: 0.55, 0.85). Although parity was inversely associated with risk of all subtypes, the RRs ranged from 0.28 (clear cell) to 0.83 (serous). Obesity was a significant risk factor only for endometrioid cancers (RR = 1.64; 95% CI: 1.00, 2.70). Our findings support a link between etiological factors and histological heterogeneity in ovarian carcinoma.

Original languageEnglish (US)
Pages (from-to)938-948
Number of pages11
JournalInternational Journal of Cancer
Issue number4
StatePublished - Aug 15 2012


  • histology
  • non-reproductive factors
  • ovarian cancer
  • prospective study
  • reproductive factors

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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