La Vecchia Carlo
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Eur J Cancer Prev. 2017 Jan;26(1):55-62. doi: 10.1097/CEJ.0000000000000217.
The present overview of ovarian cancer epidemiology summarizes the main results for a network of case-control studies in Italy and from the Collaborative Group on Epidemiological Studies of Ovarian Cancer. There are consistent inverse relations between parity, oral contraceptive use and the risk of ovarian cancer. For other menstrual and hormonal factors (i.e. early age at menarche and late menopause), there are established associations, but of limited impact on ovarian cancer incidence on a population level. Serous and endometrioid ovarian cancers (but not mucinous or clear cell types) are related to current and recent use of hormone replacement therapy in menopause. There are no strong associations with alcohol and tobacco overall, but a direct link for tobacco with (borderline) mucinous cancers, of limited impact, however, on overall ovarian cancer mortality. There are direct associations of ovarian cancer risk with height and BMI, as well as possible relations with selected dietary factors - in the absence, however, of consistent findings - and a possible inverse association with physical activity. There is a strong association with a family history of ovarian cancer (and a few selected other neoplasms, including colorectum and endometrium). Recognized risk factors explain only a limited proportion of ovarian cancer cases on a population level. A key reason for the recent favourable trends of ovarian cancer incidence and mortality in several high-income countries is the widespread use of oral contraceptive in the generations born after 1930.
本文对卵巢癌流行病学的概述总结了意大利病例对照研究网络以及卵巢癌流行病学研究协作组的主要结果。生育次数、口服避孕药的使用与卵巢癌风险之间存在一致的负相关关系。对于其他月经和激素因素（如初潮年龄早和绝经晚），虽已证实存在关联，但在人群层面上对卵巢癌发病率的影响有限。浆液性和子宫内膜样卵巢癌（但黏液性或透明细胞类型的卵巢癌并非如此）与绝经后当前及近期使用激素替代疗法有关。总体而言，饮酒和吸烟与卵巢癌没有很强的关联，但吸烟与（临界）黏液性癌存在直接联系，不过对卵巢癌总体死亡率的影响有限。卵巢癌风险与身高和体重指数直接相关，与某些特定饮食因素可能也有关系——然而，目前尚无一致的研究结果——且可能与身体活动呈负相关。卵巢癌与卵巢癌家族史（以及其他一些特定肿瘤，包括结直肠癌和子宫内膜癌）有很强的关联。在人群层面上，已确认的风险因素仅能解释有限比例的卵巢癌病例。几个高收入国家近期卵巢癌发病率和死亡率呈有利趋势的一个关键原因是1930年后出生的几代人广泛使用口服避孕药。
