Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type

Histopathological and molecular studies suggest that different histological subtypes (histotypes) of ovarian cancer have different aetiologies. Few studies have been large enough to explore reliably the effect of tubal ligation (sterilization), which has been associated with a reduced overall risk o...

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Hauptverfasser: Gaitskell, K, Green, J, Pirie, K, Reeves, G, Beral, V
Format: Journal article
Veröffentlicht: Wiley 2015
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author Gaitskell, K
Green, J
Pirie, K
Reeves, G
Beral, V
author_facet Gaitskell, K
Green, J
Pirie, K
Reeves, G
Beral, V
author_sort Gaitskell, K
collection OXFORD
description Histopathological and molecular studies suggest that different histological subtypes (histotypes) of ovarian cancer have different aetiologies. Few studies have been large enough to explore reliably the effect of tubal ligation (sterilization), which has been associated with a reduced overall risk of ovarian cancer, on different tumour histotypes. In a prospective study of 1.1 million UK women without prior cancer or bilateral oophorectomy, 8,035 ovarian cancers occurred during mean follow‐up of 13.8 years. Using a Cox proportional hazards model, we estimated adjusted relative risks of ovarian cancer associated with tubal ligation. Overall, there was substantial heterogeneity in tumour risk associated with tubal ligation for the four main histotypes, serous, endometrioid, mucinous and clear cell (heterogeneity: p < 0.0001). For serous tumours, the most common histotype (n = 3,515), risks differed significantly between high‐grade (RR: 0.77, 95% CI: 0.67–0.89) and low‐grade tumours (RR: 1.13, 95% CI: 0.89–1.42); heterogeneity: p = 0.007. Relative risks were almost halved for endometrioid (n = 690, RR: 0.54, 95% CI: 0.43–0.69) and clear cell tumours (n = 401, RR: 0.55, 95% CI: 0.39–0.77), but there was no association between tubal ligation and mucinous tumours (n = 836, RR: 0.99, 95% CI: 0.84–1.18). For the main tumour histotypes we found little variation of risk by timing of tubal ligation. The significant differences by tumour histotype are unlikely to be due to confounding and are consistent with hypotheses that high‐grade and low‐grade serous tumours have different origins, and that some endometrioid and clear cell tumours might arise from cells and/or carcinogens travelling through the fallopian tubes.
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spelling oxford-uuid:4adc1e5c-7f9f-494f-8f7c-2dec894926692022-03-26T15:40:06ZTubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological typeJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4adc1e5c-7f9f-494f-8f7c-2dec89492669Symplectic Elements at OxfordWiley2015Gaitskell, KGreen, JPirie, KReeves, GBeral, VHistopathological and molecular studies suggest that different histological subtypes (histotypes) of ovarian cancer have different aetiologies. Few studies have been large enough to explore reliably the effect of tubal ligation (sterilization), which has been associated with a reduced overall risk of ovarian cancer, on different tumour histotypes. In a prospective study of 1.1 million UK women without prior cancer or bilateral oophorectomy, 8,035 ovarian cancers occurred during mean follow‐up of 13.8 years. Using a Cox proportional hazards model, we estimated adjusted relative risks of ovarian cancer associated with tubal ligation. Overall, there was substantial heterogeneity in tumour risk associated with tubal ligation for the four main histotypes, serous, endometrioid, mucinous and clear cell (heterogeneity: p < 0.0001). For serous tumours, the most common histotype (n = 3,515), risks differed significantly between high‐grade (RR: 0.77, 95% CI: 0.67–0.89) and low‐grade tumours (RR: 1.13, 95% CI: 0.89–1.42); heterogeneity: p = 0.007. Relative risks were almost halved for endometrioid (n = 690, RR: 0.54, 95% CI: 0.43–0.69) and clear cell tumours (n = 401, RR: 0.55, 95% CI: 0.39–0.77), but there was no association between tubal ligation and mucinous tumours (n = 836, RR: 0.99, 95% CI: 0.84–1.18). For the main tumour histotypes we found little variation of risk by timing of tubal ligation. The significant differences by tumour histotype are unlikely to be due to confounding and are consistent with hypotheses that high‐grade and low‐grade serous tumours have different origins, and that some endometrioid and clear cell tumours might arise from cells and/or carcinogens travelling through the fallopian tubes.
spellingShingle Gaitskell, K
Green, J
Pirie, K
Reeves, G
Beral, V
Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
title Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
title_full Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
title_fullStr Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
title_full_unstemmed Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
title_short Tubal ligation and ovarian cancer risk in a large cohort: Substantial variation by histological type
title_sort tubal ligation and ovarian cancer risk in a large cohort substantial variation by histological type
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AT greenj tuballigationandovariancancerriskinalargecohortsubstantialvariationbyhistologicaltype
AT piriek tuballigationandovariancancerriskinalargecohortsubstantialvariationbyhistologicaltype
AT reevesg tuballigationandovariancancerriskinalargecohortsubstantialvariationbyhistologicaltype
AT beralv tuballigationandovariancancerriskinalargecohortsubstantialvariationbyhistologicaltype