Population distribution of lifetime risk of ovarian cancer in the United States.

Abstract

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.

• Authors: Celeste Leigh Pearce, Daniel O Stram, Roberta B Ness, Douglas A Stram, Lynda D Roman, Claire Templeman, Alice W Lee, Usha Menon, Peter A Fasching, Jessica N McAlpine, Jennifer A Doherty, Francesmary Modugno, Joellen M Schildkraut, Mary Anne Rossing, David G Huntsman, Anna H Wu, Andrew Berchuck, Malcolm C Pike, Paul D P Pharoah
• Journal: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology (Cancer Epidemiol Biomarkers Prev) Vol. 24 Issue 4 Pg. 671-676 (Apr 2015) ISSN: 1538-7755 [Electronic] United States
• PMID: 25623732 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S.)
• Copyright: ©2015 American Association for Cancer Research.

Chemical References

• Contraceptives, Oral

Topics

• Contraceptives, Oral
• Demography
• Female
• Humans
• Life Tables
• Ovarian Neoplasms (epidemiology)
• Risk Factors
• Sterilization, Tubal
• United States (epidemiology)