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. 2013 May;24(5):989-1004.
doi: 10.1007/s10552-013-0174-4. Epub 2013 Mar 2.

Cigarette smoking and risk of ovarian cancer: a pooled analysis of 21 case-control studies

Mette T Faber  1 , Susanne K Kjær, Christian Dehlendorff, Jenny Chang-Claude, Klaus K Andersen, Estrid Høgdall, Penelope M Webb, Susan J Jordan; Australian Cancer Study (Ovarian Cancer); Australian Ovarian Cancer Study Group; Mary Anne Rossing, Jennifer A Doherty, Galina Lurie, Pamela J Thompson, Michael E Carney, Marc T Goodman, Roberta B Ness, Francesmary Modugno, Robert P Edwards, Clareann H Bunker, Ellen L Goode, Brooke L Fridley, Robert A Vierkant, Melissa C Larson, Joellen Schildkraut, Daniel W Cramer, Kathryn L Terry, Allison F Vitonis, Elisa V Bandera, Sara H Olson, Melony King, Urmila Chandran, Lambertus A Kiemeney, Leon F A G Massuger, Anne M van Altena, Sita H Vermeulen, Louise Brinton, Nicolas Wentzensen, Jolanta Lissowska, Hannah P Yang, Kirsten B Moysich, Kunle Odunsi, Karin Kasza, Oluwatosin Odunsi-Akanji, Honglin Song, Paul Pharaoh, Mitul Shah, Alice S Whittemore, Valerie McGuire, Weiva Sieh, Rebecca Sutphen, Usha Menon, Simon A Gayther, Susan J Ramus, Aleksandra Gentry-Maharaj, Celeste Leigh Pearce, Anna H Wu, Malcolm C Pike, Harvey A Risch, Allan Jensen; Ovarian Cancer Association Consortium
Affiliations

Cigarette smoking and risk of ovarian cancer: a pooled analysis of 21 case-control studies

Mette T Faber et al. Cancer Causes Control. 2013 May.

Abstract

Purpose: The majority of previous studies have observed an increased risk of mucinous ovarian tumors associated with cigarette smoking, but the association with other histological types is unclear. In a large pooled analysis, we examined the risk of epithelial ovarian cancer associated with multiple measures of cigarette smoking with a focus on characterizing risks according to tumor behavior and histology.

Methods: We used data from 21 case-control studies of ovarian cancer (19,066 controls, 11,972 invasive and 2,752 borderline cases). Study-specific odds ratios (OR) and 95 % confidence intervals (CI) were obtained from logistic regression models and combined into a pooled odds ratio using a random effects model.

Results: Current cigarette smoking increased the risk of invasive mucinous (OR = 1.31; 95 % CI: 1.03-1.65) and borderline mucinous ovarian tumors (OR = 1.83; 95 % CI: 1.39-2.41), while former smoking increased the risk of borderline serous ovarian tumors (OR = 1.30; 95 % CI: 1.12-1.50). For these histological types, consistent dose-response associations were observed. No convincing associations between smoking and risk of invasive serous and endometrioid ovarian cancer were observed, while our results provided some evidence of a decreased risk of invasive clear cell ovarian cancer.

Conclusions: Our results revealed marked differences in the risk profiles of histological types of ovarian cancer with regard to cigarette smoking, although the magnitude of the observed associations was modest. Our findings, which may reflect different etiologies of the histological types, add to the fact that ovarian cancer is a heterogeneous disease.

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Conflict of interest statement

Conflict of interest The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Risk of invasive ovarian cancer associated with cigarette smoking status, by study site and overall. OR and 95 % CI were estimated using logistic regression models. a Serous ovarian cancer, current versus never smokers, b serous ovarian cancer, former versus never smokers, c mucinous ovarian cancer, current versus never smokers, and d mucinous ovarian cancer former versus never smokers. Each square and line in the figures represents the odds ratio and 95% confidence intervals from each study and the diamond at the bottom of the plot represents the pooled odds ratio. The size of the squares indicates the size of each study
Fig. 2
Fig. 2
Risk of borderline ovarian tumors associated with cigarette smoking status, by study site and overall. OR and 95 % CI were estimated using logistic regression models. a Serous borderline ovarian tumors, current versus never smokers, b serous borderline ovarian tumors, former versus never smokers, c mucinous borderline ovarian tumors, current versus never smokers, and d mucinous borderline ovarian tumors, former versus never smokers. Each square and line in the figures represents the odds ratio and 95% confidence intervals from each study and the diamond at the bottom of the plot represents the pooled odds ratio. The size of the squares indicates the size of each study
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References

    1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin. 2011;61(2):69–90. - PubMed
    1. Karim-Kos HE, de Vries E, Soerjomataram I, et al. Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. Eur J Cancer. 2008;44(10):1345–1389. - PubMed
    1. Jordan SJ, Whiteman DC, Purdie DM, et al. Does smoking increase risk of ovarian cancer? A systematic review. Gynecol Oncol. 2006;103(3):1122–1129. - PubMed
    1. Gates MA, Rosner BA, Hecht JL, et al. Risk factors for epithelial ovarian cancer by histologic subtype. Am J Epidemiol. 2010;171(1):45–53. - PMC - PubMed
    1. Gram IT, Lukanova A, Brill I, et al. Cigarette smoking and risk of histological subtypes of epithelial ovarian cancer in the EPIC cohort study. Int J Cancer. 2012;130(9):2204–2210. - PubMed

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