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While the risk of ovarian cancer clearly reduces with each full-term pregnancy, the effect of incomplete pregnancies is unclear. We investigated whether incomplete pregnancies (miscarriages and induced abortions) are associated with risk of epithelial ovarian cancer. This observational study was carried out in female participants of the European Prospective Investigation into Cancer and Nutrition (EPIC). A total of 274,442 women were followed from 1992 until 2010. The baseline questionnaire elicited information on miscarriages and induced abortions, reproductive history, and lifestyle-related factors. During a median follow-up of 11.5 years, 1,035 women were diagnosed with incident epithelial ovarian cancer. Despite the lack of an overall association (ever vs. never), risk of ovarian cancer was higher among women with multiple incomplete pregnancies (HR >= 4vs.0: 1.74, 95% CI: 1.20-2.70; number of cases in this category: n = 23). This association was particularly evident for multiple miscarriages (HR >= 4vs.0: 1.99, 95% CI: 1.06-3.73; number of cases in this category: n = 10), with no significant association for multiple induced abortions (HR >= 4vs.0: 1.46, 95% CI: 0.68-3.14; number of cases in this category: n = 7). Our findings suggest that multiple miscarriages are associated with an increased risk of epithelial ovarian cancer, possibly through a shared cluster of etiological factors or a common underlying pathology. These findings should be interpreted with caution as this is the first study to show this association and given the small number of cases in the highest exposure categories.

Titel:	Multiple Miscarriages Are Associated with the Risk of Ovarian Cancer: Results from the European Prospective Investigation into Cancer and Nutrition
Autor/in / Beteiligte Person:	Fedirko, Veronika ; Lukanova, Annekatrin ; H. Bas Bueno-de-Mesquita ; Butt, Salma ; Riboli, Elio ; Tjønneland, Anne ; Chabbert-Buffet, Nathalie ; Plada, Maria ; Pala, Valeria ; Palli, Domenico ; Romieu, Isabelle ; Schouten, Leo J. ; Overvad, Kim ; Roy F.P.M. Kruitwagen ; Adarakis, George ; Marieke G.M. Braem ; Gram, Inger T. ; Jirström, Karin ; Rinaldi, Sabina ; Tumino, Rosario ; Aurelio Barricarte Gurrea ; Gavrilyuk, Oxana ; Floegel, Anna ; José Ramón Quirós ; María José Sánchez ; Tsilidis, Konstantinos K. ; Christina Marie Braüner ; María Dolores Chirlaque ; Sacerdote, Carlotta ; Bonet, Catalina ; Lund, Eiliv ; Lundin, Eva ; Teucher, Birgit ; Hansen, Louise ; Larrañaga, Nerea ; Kaaks, Rudolf ; Trichopoulou, Antonia ; Boeing, Heiner ; Wark, Petra A. ; Ohlson, Nina ; Allen, Naomi E. ; Galasso, Rocco ; Idahl, Annika ; Wareham, Nicholas J. ; Khaw, Kay-Tee ; N. Charlotte Onland-Moret ; Petra H.M. Peeters ; Clavel-Chapelon, Françoise ; [Braem,MGM ; Onland-Moret,NC ; Peeters,PHM] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. [Schouten,LJ] Department of Epidemiology, GROW - School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands. [Kruitwagen, RFPM] Department of Obstetrics and Gynaecology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands. [Lukanova,A ; Teuche,B ; Kaaks,R] Division of Cancer Epidemiology, German Cancer Research Center, Heidelberg, Germany. [Allen,NE ; KK] Cancer Epidemiology Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, United Kingdom. [Wark,PA] Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary’s Campus, London, United Kingdom. [Tjønneland,A ; Hansen,L] Institute of Cancer Epidemiology, Danish Cancer Society, Copenhagen, Denmark. [Braü ner,MC ; Overvad,K] Department of Epidemiology, School of Public Health, Aarhus University, Aarhus, Denmark. [Clavel-Chapelon,F] Inserm, Centre for Research in Epidemiology and Population Health, U1018, Institut Gustave Roussy, Villejuif, France. [Chabbert-Buffet,N] Gynecology Department Hospital Tenon AP-HP, Paris, France. University Pierre and Marie Curie, Paris, France. [Floege,A ; Boeing,H] Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany. [Trichopoulou,A] WHO Collaborating Center for Food and Nutrition Policies, Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece. [Trichopoulou,A ; Adarakis,G ; Plada,M] Hellenic Health Foundation, Athens, Greece. [Rinaldi,S ; Fedirko,V ; Romieu,I] Section of Nutrition and Metabolism, Nutritional Epidemiology Group, International Agency for Research on Cancer, Lyon, France. [Pala,V] Nutritional Epidemiology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy. [Galasso,R] Istituto di Ricovero e Cura a Carattere Scientifico - Centro di Riferimento Oncologico di Basilicata, Unit of Clinical Epidemiolgy, Biostatistics and Cancer Registry, Rionero in Vulture, Italy. [Sacerdote,C] Center for Cancer Prevention (CPOPiemonte), Turin, Italy. Human Genetic Foundation, Torino, Italy. [Palli,D] Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute – ISPO, Florence, Italy. [Tumino,R] Cancer Registry and Histopathology Unit, 'Civile - M.P. Arezzo' Hospital, ASP 7 Ragusa, Italy. [Bueno-de-Mesquita,HB] National Institute for Public Health and the Environment, Bilthoven, The Netherlands. Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands. [Gram,IT ; Gavrilyuk,O ; Lund,E] Institute of Community Medicine, Faculty of Health Sciences, University of Tromsø, Norway. [Sánchez,MJ] Escuela Andaluza de Salud Publica, Granada, Spain. [Sánchez,MJ ; Chirlaque,MD ; Larrañaga,N ; Gurrea,AB] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Barcelona, Spain. [Bonet,C] Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology, Barcelona, Spain. [Chirlaque,MD] Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública-CIBERESP), Barcelona, Spain. Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain. [Larrañaga,N] Public Health Department of Gipuzkoa, Basque Government, Spain. [Gurrea,AB] Navarre Public Health Institute, Pamplona, Spain. [Quirós,JR] Public Health and Health Planning Directorate, Asturias, Spain. [Idah,A] Department of Clinical Sciences, Obstetrics and Gynecology, Umea University, Umea, Sweden. Department of Public Health and Clinical Medicine, Nutritional research, Umea University, Umea, Sweden. [Ohlson,N ; Lundin,E] Department of Medical Biosciences, Pathology, Umea University, Umea, Sweden. [Jirström,K] Department of Clinical Sciences, Division of Pathology, Lund University, Skane University Hospital, Lund, Sweden. [Butt,S] Department of Surgery, Lund University, Skane University Hospital, Malmö , Sweden. [Tsilidis,KK] Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece. [Khaw,KT] University of Cambridge, Cambridge, United Kingdom. [Wareham,N] MRC Epidemiology Unit Cambridge, Cambridge, United Kingdom. [Riboli,E] School of Public Health, Imperial College London, London, United Kingdom. ; Funding: This study was financially supported by the Dutch Cancer Society (UU2008-4267). The coordination of EPIC is financially supported by the European Commission (DG-SANCO) and the International Agency for Research on Cancer. The national cohorts are supported by Danish Cancer Society (Denmark) ; Ligue Contre le Cancer, Institut Gustave Roussy, Mutuelle Ge´ne´rale de l’Education Nationale, Institut National de la Sante´ et de la Recherche Me´dicale (INSERM) (France) ; Deutsche Krebshilfe, Deutsches Krebsforschungszentrum and Federal Ministry of Education and Research (Germany) ; the Hellenic Health Foundation, the Stavros Niarchos Foundation and the Hellenic Ministry of Health and Social Solidarity (Greece) ; Italian Association for Research on Cancer (AIRC) and National Research Council (Italy) ; Dutch Ministry of Public Health, Welfare and Sports (VWS), Netherlands Cancer Registry (NKR), LK Research Funds, Dutch Prevention Funds, Dutch ZON (Zorg Onderzoek Nederland), World Cancer Research Fund (WCRF), Statistics Netherlands (The Netherlands) ; Health Research Fund (FIS), Regional Governments of Andalucı´a, Asturias, Basque Country, Murcia (no. 6236) and Navarra, ISCIII RETIC (RD06/0020) (Spain) ; Swedish Cancer Society, Swedish Scientific Council and Regional Government of Ska°ne and Va¨sterbotten (Sweden) ; Cancer Research United Kingdom, Medical Research Council (United Kingdom). ; Epidemiologie ; Obstetrie & Gynaecologie
Link:	View record in OpenAIRE (Volltext) Volltext
Zeitschrift:	Braem, M G M, Onland-Moret, N C, Schouten, L J, Kruitwagen, R F P M, Lukanova, A, Allen, Jg. 7 (2012-05-18), Heft 5, p e37141
Veröffentlichung:	PUBLIC LIBRARY SCIENCE, 2012
Medientyp:	unknown
ISSN:	1932-6203 (print)
Schlagwort:	Questionnaires Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Models, Statistical::Proportional Hazards Models [Medical Subject Headings] Epidemiology lcsh:Medicine Abortion Miscarriage Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] Cohort Studies Pregnancy Surveys and Questionnaires Clinical Epidemiology Neoplasms, Glandular and Epithelial Prospective Studies Prospective cohort study lcsh:Science Reproductive History Phenomena and Processes::Reproductive and Urinary Physiological Phenomena::Reproductive Physiological Phenomena::Reproductive Physiological Processes::Reproduction::Pregnancy [Medical Subject Headings] Ovarian Neoplasms Multidisciplinary VDP::Medisinske Fag: 700::Helsefag: 800::Samfunnsmedisin, sosialmedisin: 801 Cancer Risk Factors Femenino Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Data Collection::Questionnaires [Medical Subject Headings] Obstetrics and Gynecology Geographicals::Geographic Locations::Europe [Medical Subject Headings] European Prospective Investigation into Cancer and Nutrition Ovarian Cancer Humanos Diseases::Neoplasms::Neoplasms by Site::Endocrine Gland Neoplasms::Ovarian Neoplasms [Medical Subject Headings] Europe Oncology Observational Studies Hormonal therapy Medicine Female Europa Cancer Prevention Diseases::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial [Medical Subject Headings] Cancer Epidemiology Cohort study Research Article medicine.medical_specialty Abortion, Habitual Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Prospective Studies [Medical Subject Headings] Clinical Research Design Diseases::Female Urogenital Diseases and Pregnancy Complications::Pregnancy Complications::Abortion, Spontaneous::Abortion, Habitual [Medical Subject Headings] Reproduktionsmedicin och gynekologi Risk Assessment Obstetrics, Gynecology and Reproductive Medicine medicine Humans Proportional Hazards Models Gynecology Cancer och onkologi business.industry lcsh:R Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Assessment [Medical Subject Headings] Cancers and Neoplasms medicine.disease Neoplasias Glandulares y Epiteliales Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Medical History Taking::Reproductive History [Medical Subject Headings] Check Tags::Female [Medical Subject Headings] Other Clinical Medicine Cancer and Oncology Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies [Medical Subject Headings] Miscarriage and Stillbirth lcsh:Q Neoplasias Ováricas VDP::Medical disciplines: 700::Health sciences: 800::Community medicine, Social medicine: 801 Ovarian cancer business Estudios de Cohortes Gynecological Tumors
Sonstiges:	Nachgewiesen in: OpenAIRE Sprachen: English File Description: application/pdf Language: English Rights: OPEN

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Multiple Miscarriages Are Associated with the Risk of Ovarian Cancer: Results from the European Prospective Investigation into Cancer and Nutrition