Menstrual pain and risk of epithelial ovarian cancer: Results from the Ovarian Cancer Association Consortium
Abstract
Menstrual pain, a common gynecological condition, has been associated with increased risk of ovarian cancer in some, but not all studies. Furthermore, potential variations in the association between menstrual pain and ovarian cancer by histologic subtype have not been adequately evaluated due to lack of power. We assessed menstrual pain using either direct questions about having experienced menstrual pain, or indirect questions about menstrual pain as indication for use of hormones or medications. We used multivariate logistic regression to calculate the odds ratio (OR) for the association between severe menstrual pain and ovarian cancer, adjusting for potential confounders and multinomial logistic regression to calculate ORs for specific histologic subtypes. We observed no association between ovarian cancer and menstrual pain assessed by indirect questions. Among studies using direct question, severe pain was associated with a small but significant increase in overall risk of ovarian cancer (OR = 1.07, 95% CI: 1.01–1.13), after adjusting for endometriosis and other potential confounders. The association appeared to be more relevant for clear cell (OR = 1.48, 95% CI: 1.10–1.99) and serous borderline (OR = 1.31, 95% CI: 1.05–1.63) subtypes. In this large international pooled analysis of case‐control studies, we observed a small increase in risk of ovarian cancer for women reporting severe menstrual pain. While we observed an increased ovarian cancer risk with severe menstrual pain, the possibility of recall bias and undiagnosed endometriosis cannot be excluded. Future validation in prospective studies with detailed information on endometriosis is needed.
Document Details
- Document Type
- Pub Defense Publication
- Publication Date
- Sep 21, 2017
- Source ID
- 10.1002/ijc.31010
Entities
People
- Allison F. Vitonis
- Ana Babic
- Andrew Berchuck
- Anna H. Wu
- Celeste Leigh Pearce
- Daniel W. Cramer
- Francesmary Modugno
- Harvey A. Risch
- Holly R Harris
- Jennifer A Doherty
- Joellen Schildkraut
- Kathryn L. Terry
- Kirsten B. Moysich
- Kristine Wicklund
- Linda J. Titus
- Marc T. Goodman
- Mary Anne Rossing
- Penelope M. Webb
- Roberta B. Ness
- Susan J. Jordan
- Susanne Krüger Kjaer
- The Australian Ovarian Cancer Study Group
Organizations
- Cedars-Sinai Medical Center
- Danish Cancer Society
- Duke University
- Fred Hutchinson Cancer Center
- Geisel School of Medicine
- Harvard Medical School
- Harvard University
- National Institutes of Health
- QIMR Berghofer Medical Research Institute
- Roswell Park Comprehensive Cancer Center
- United States Army Medical Research and Development Command
- United States Department of Defense
- University of Copenhagen
- University of Michigan
- University of Pittsburgh
- University of Southern California
- University of Texas at Austin
- University of Utah
- University of Virginia
- University of Washington
- Yale School of Public Health