TY - JOUR
T1 - Racial Differences in the Association of Endometriosis and Uterine Leiomyomas with the Risk of Ovarian Cancer
AU - Harris, Holly R.
AU - Peres, Lauren C.
AU - Johnson, Courtney E.
AU - Guertin, Kristin A.
AU - Beeghly, Alicia
AU - Bandera, Elisa V.
AU - Bethea, Traci N.
AU - Joslin, Charlotte E.
AU - Wu, Anna H.
AU - Moorman, Patricia G.
AU - Ochs-Balcom, Heather M.
AU - Petrick, Jessica L.
AU - Setiawan, Veronica W.
AU - Rosenberg, Lynn
AU - Schildkraut, Joellen M.
AU - Myers, Evan
N1 - Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/6/1
Y1 - 2023/6/1
N2 - OBJECTIVE:To evaluate associations between endometriosis and uterine leiomyomas with ovarian cancer risk by race and the effect of hysterectomy on these associations.METHODS:We used data from four case-control studies and two case-control studies nested within prospective cohorts in the OCWAA (Ovarian Cancer in Women of African Ancestry) consortium. The study population included 3,124 Black participants and 5,458 White participants, of whom 1,008 Black participants and 2,237 White participants had ovarian cancer. Logistic regression was used to calculate odds ratios (ORs) and 95%CIs for the associations of endometriosis and leiomyomas with ovarian cancer risk, by race, stratified by histotype and hysterectomy.RESULTS:The prevalences of endometriosis and leiomyomas were 6.4%and 43.2%among Black participants and 7.0%and 21.5%among White participants, respectively. Endometriosis was associated with an increased risk of endometrioid and clear-cell ovarian cancer in both racial groups (eg, OR for endometrioid tumors for Black and White participants 7.06 [95%CI 3.86-12.91] and 2.17 [95%CI 1.36-3.45], respectively, Phetereogeneity=.003). The association between endometriosis and ovarian cancer risk in White participants was stronger in those without hysterectomy, but no difference was observed in Black participants (all Pinteraction≥.05). Leiomyomas were associated with an elevated risk of ovarian cancer only in those without hysterectomy in both Black (OR 1.34, 95%CI 1.11-1.62) and White (OR 1.22, 95%CI 1.05-1.41) participants (all Pinteraction≥.05).CONCLUSIONS:Black and White participants with endometriosis had a higher risk of ovarian cancer, and hysterectomy modified this association among White participants. Leiomyomas were associated with an increased risk of ovarian cancer in both racial groups, with hysterectomy modifying the risk in both groups. Understanding how racial differences in access to care and treatment options (eg, hysterectomy) may help guide future risk reduction strategies.
AB - OBJECTIVE:To evaluate associations between endometriosis and uterine leiomyomas with ovarian cancer risk by race and the effect of hysterectomy on these associations.METHODS:We used data from four case-control studies and two case-control studies nested within prospective cohorts in the OCWAA (Ovarian Cancer in Women of African Ancestry) consortium. The study population included 3,124 Black participants and 5,458 White participants, of whom 1,008 Black participants and 2,237 White participants had ovarian cancer. Logistic regression was used to calculate odds ratios (ORs) and 95%CIs for the associations of endometriosis and leiomyomas with ovarian cancer risk, by race, stratified by histotype and hysterectomy.RESULTS:The prevalences of endometriosis and leiomyomas were 6.4%and 43.2%among Black participants and 7.0%and 21.5%among White participants, respectively. Endometriosis was associated with an increased risk of endometrioid and clear-cell ovarian cancer in both racial groups (eg, OR for endometrioid tumors for Black and White participants 7.06 [95%CI 3.86-12.91] and 2.17 [95%CI 1.36-3.45], respectively, Phetereogeneity=.003). The association between endometriosis and ovarian cancer risk in White participants was stronger in those without hysterectomy, but no difference was observed in Black participants (all Pinteraction≥.05). Leiomyomas were associated with an elevated risk of ovarian cancer only in those without hysterectomy in both Black (OR 1.34, 95%CI 1.11-1.62) and White (OR 1.22, 95%CI 1.05-1.41) participants (all Pinteraction≥.05).CONCLUSIONS:Black and White participants with endometriosis had a higher risk of ovarian cancer, and hysterectomy modified this association among White participants. Leiomyomas were associated with an increased risk of ovarian cancer in both racial groups, with hysterectomy modifying the risk in both groups. Understanding how racial differences in access to care and treatment options (eg, hysterectomy) may help guide future risk reduction strategies.
UR - https://www.scopus.com/pages/publications/85164461887
U2 - 10.1097/AOG.0000000000005191
DO - 10.1097/AOG.0000000000005191
M3 - Article
C2 - 37159277
AN - SCOPUS:85164461887
SN - 0029-7844
VL - 141
SP - 1124
EP - 1138
JO - Obstetrics and Gynecology
JF - Obstetrics and Gynecology
IS - 6
ER -