Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Department of Obstetrics and Gynecology, Seinäjoki Central Hospital, Seinäjoki, Finland.
Acta Oncol. 2021 Jul;60(7):850-855. doi: 10.1080/0284186X.2021.1919754. Epub 2021 May 17.
Parity is known to have a protective effect as regards ovarian cancer, but its effect on the different histological subtypes of ovarian cancer is not well known. The impact of parity on the incidence of ovarian cancer subtypes was studied.
All Finnish women diagnosed 1994-2013 with ovarian cancer for the first time were included. Altogether, 5412 cases of ovarian cancer were identified in the Finnish Cancer Registry and stratified according to morphology into serous, mucinous, endometrioid, clear cell and others. Five age-matched controls were randomly selected for each case from the Finnish National Population Registry. Data on postmenopausal hormonal therapy were derived from the Registry of Prescribed drugs and used as cofactors. Multivariate conditional logistic regression for matched case-control data was used to examine the associations between parity parameters and ovarian cancer risk.
Parous women had lower risk than nulliparous women in getting ovarian cancer of any type under age of 55 years. The odds ratio (OR) for serous cancer was 0.65 (95% confidence interval 0.56-0.77), for mucinous cancer 0.66 (0.52-0.83), for endometrioid cancer 0.52 (0.40-0.68), for clear-cell cancer 0.30 (0.19-0.46) and for other types 0.59 (0.43-0.80). In women aged 55 or older, the respective ORs were 0.86 (0.75-0.99), 0.78 (0.57-1.07), 0.61 (0.47-0.79), 0.44 (0.29-0.66) and 0.74 (0.57-0.95), adjusted for hormone therapy. Number of childbirths was associated with a trend toward reduction of risk, especially in serous and clear-cell cancers. Higher age at first birth was associated with higher risk of clear-cell cancer but otherwise age at first or last birth did not have an impact on the incidence of cancer subtypes.
Childbirths decrease the risk of all histologic subtypes of epithelial ovarian cancer in women in premenopausal and postmenopausal age.
众所周知，生育次数与卵巢癌的保护作用相关，但它对不同组织学类型的卵巢癌的影响尚不清楚。本研究旨在探讨生育次数对卵巢癌亚型发病的影响。
纳入 1994 年至 2013 年间芬兰首次被诊断为卵巢癌的所有女性。在芬兰癌症登记处共发现 5412 例卵巢癌病例，根据形态学分为浆液性、黏液性、子宫内膜样、透明细胞和其他类型。从芬兰国家人口登记处为每个病例随机选择 5 个年龄匹配的对照。从处方药物登记处获得绝经后激素治疗的数据，并将其作为协变量。采用病例对照数据的多变量条件逻辑回归来检验生育参数与卵巢癌风险之间的关联。
与未生育的女性相比，生育过的女性在 55 岁以下患任何类型卵巢癌的风险较低。浆液性癌的比值比（OR）为 0.65（95%置信区间 0.56-0.77），黏液性癌为 0.66（0.52-0.83），子宫内膜样癌为 0.52（0.40-0.68），透明细胞癌为 0.30（0.19-0.46），其他类型为 0.59（0.43-0.80）。对于 55 岁或以上的女性，相应的 OR 分别为 0.86（0.75-0.99）、0.78（0.57-1.07）、0.61（0.47-0.79）、0.44（0.29-0.66）和 0.74（0.57-0.95），均调整了激素治疗的影响。分娩次数与风险降低呈趋势相关，尤其是在浆液性和透明细胞性癌症中。初产年龄较大与透明细胞癌风险增加相关，而初产或经产年龄对癌症亚型的发生没有影响。
生育降低了绝经前和绝经后女性所有组织学类型上皮性卵巢癌的风险。
