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European Journal of Epidemiology
Published in: European Journal of Epidemiology 11/2020

01-11-2020 | Hirsutism | META-ANALYSIS

Offspring sex and risk of epithelial ovarian cancer: a multinational pooled analysis of 12 case–control studies

Authors: Francesmary Modugno, Zhuxuan Fu, Susan J. Jordan, AOCS Group, Jenny Chang-Claude, Renée T. Fortner, Marc T. Goodman, Kirsten B. Moysich, Joellen M. Schildkraut, Andrew Berchuck, Elisa V. Bandera, Bo Qin, Rebecca Sutphen, John R. McLaughlin, Usha Menon, Susan J. Ramus, Simon A. Gayther, Aleksandra Gentry-Maharaj, Chloe Karpinskyj, Celeste L. Pearce, Anna H. Wu, Harvey A. Risch, Penelope M. Webb

Published in: European Journal of Epidemiology | Issue 11/2020

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Abstract

While childbearing protects against risk of epithelial ovarian cancer (EOC), few studies have explored the impact on maternal EOC risk of sex of offspring, which may affect the maternal environment during pregnancy. We performed a pooled analysis among parous participants from 12 case–controls studies comprising 6872 EOC patients and 9101 controls. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using multivariable logistic regression for case–control associations and polytomous logistic regression for histotype-specific associations, all adjusted for potential confounders. In general, no associations were found between offspring sex and EOC risk. However, compared to bearing only female offspring, bearing one or more male offspring was associated with increased risk of mucinous EOC (OR = 1.45; 95% CI = 1.01-2.07), which appeared to be limited to women reporting menarche before age 13 compared to later menarche (OR = 1.71 vs 0.99; P-interaction = 0.02). Bearing increasing numbers of male offspring was associated with greater risks of mucinous tumors (OR = 1.31, 1.84, 2.31, for 1, 2 and 3 or more male offspring, respectively; trend-p = 0.005). Stratifying by hormonally-associated conditions suggested that compared to bearing all female offspring, bearing a male offspring was associated with lower risk of endometrioid cancer among women with a history of adult acne, hirsutism, or polycystic ovary syndrome (OR = 0.49, 95% CI = 0.28-0.83) but with higher risk among women without any of those conditions (OR = 1.64 95% CI = 1.14–2.34; P-interaction = 0.003). Offspring sex influences the childbearing-EOC risk relationship for specific histotypes and conditions. These findings support the differing etiologic origins of EOC histotypes and highlight the importance of EOC histotype-specific epidemiologic studies. These findings also suggest the need to better understand how pregnancy affects EOC risk
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Metadata
Title
Offspring sex and risk of epithelial ovarian cancer: a multinational pooled analysis of 12 case–control studies
Authors
Francesmary Modugno
Zhuxuan Fu
Susan J. Jordan
AOCS Group
Jenny Chang-Claude
Renée T. Fortner
Marc T. Goodman
Kirsten B. Moysich
Joellen M. Schildkraut
Andrew Berchuck
Elisa V. Bandera
Bo Qin
Rebecca Sutphen
John R. McLaughlin
Usha Menon
Susan J. Ramus
Simon A. Gayther
Aleksandra Gentry-Maharaj
Chloe Karpinskyj
Celeste L. Pearce
Anna H. Wu
Harvey A. Risch
Penelope M. Webb
Publication date
01-11-2020
Publisher
Springer Netherlands
Published in
European Journal of Epidemiology / Issue 11/2020
Print ISSN: 0393-2990
Electronic ISSN: 1573-7284
DOI
https://doi.org/10.1007/s10654-020-00682-9

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