Journal
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
Volume 24, Issue 4, Pages 671-676Publisher
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1055-9965.EPI-14-1128
Keywords
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Funding
- Kathryn Sladek Smith to the Ovarian Cancer Research Fund
- NIH [P30 CA14089, R01 CA61132, P01 CA17054, N01 PC67010, R03 CA113148, R01 CA141154, R03 CA115195, R01 CA112523, R01 CA87538, R01 CA76016, R01 CA95023, R01 CA126841, K07-CA80668]
- NIH/National Center for Research Resources/General Clinical Research Center [MO1 RR000056]
- California Cancer Research Program [0001389V20170, 2110200]
- Eve Appeal
- Oak Foundation
- Women's Health Theme of the UK National Institute of Health Research supported University College London Hospital/University College London Comprehensive Biomedical Research Centre
- US Army Medical Research and Materiel Command [DAMD 17-02-1-0669, DAMD 17-02-1-0666]
- Roswell Park Alliance Foundation
- American Cancer Society
- National Institute of Environmental Health Sciences [T32ES013678]
- Cancer Research UK [C490/A10124, C490/A16561]
- Cancer Research UK [16561] Funding Source: researchfish
- The Francis Crick Institute
- Cancer Research UK [10124] Funding Source: researchfish
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Background: In U.S. women, lifetime risk of ovarian cancer is 1.37%, but some women are at a substantially lower or higher risk than this average. Methods: We have characterized the distribution of lifetime risk in the general population. Published data on the relative risks and their variances for five well-accepted risk and protective factors for ovarian cancer, oral contraceptive use, parity, tubal ligation, endometriosis, and first-degree family history of ovarian cancer in conjunction with a genetic risk score using genome-wide significant common, low penetrance variants were used. The joint distribution of these factors (i.e., risk/protective factor profiles) was derived using control data from four U.S. population-based studies, providing a broad representation of women in the United States. Results: A total of 214 combinations of risk/protective factors were observed, and the lifetime risk estimates ranged from 0.35% [95% confidence interval (CI), 0.29-0.42] to 8.78% (95% CI, 7.10-10.9). Among women with lifetime risk ranging from 4% to 9%, 73% had no family history of ovarian cancer; most of these women had a self-reported history of endometriosis. Conclusions: Profiles including the known modifiable protective factors of oral contraceptive use and tubal ligation were associated with a lower lifetime risk of ovarian cancer. Oral contraceptive use and tubal ligation were essentially absent among the women at 4% to 9% lifetime risk. Impact: This work demonstrates that there are women in the general population who have a much higher than average lifetime risk of ovarian cancer. Preventive strategies are available. Should effective screening become available, higher than average risk women can be identified. Cancer Epidemiol Biomarkers Prev; 24(4); 671-6. (C) 2015 AACR.
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