Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies

• Published in: American journal of epidemiology Vol. 185; no. 1; pp. 8 - 20
• Main Authors: Rasmussen, Christina B, Kjaer, Susanne K, Albieri, Vanna, Bandera, Elisa V, Doherty, Jennifer A, Høgdall, Estrid, Webb, Penelope M, Jordan, Susan J, Rossing, Mary Anne, Wicklund, Kristine G, Goodman, Marc T, Modugno, Francesmary, Moysich, Kirsten B, Ness, Roberta B, Edwards, Robert P, Schildkraut, Joellen M, Berchuck, Andrew, Olson, Sara H, Kiemeney, Lambertus A, Massuger, Leon F A G, Narod, Steven A, Phelan, Catherine M, Anton-Culver, Hoda, Ziogas, Argyrios, Wu, Anna H, Pearce, Celeste L, Risch, Harvey A, Jensen, Allan
• Format: Journal Article
• Language: English
• Published: United States Oxford University Press 01.01.2017
• Subjects: Carcinoma, Ovarian Epithelial; Case-Control Studies; Comorbidity; Contraceptives, Oral, Hormonal - administration & dosage; Family Health; Female; Genetic Predisposition to Disease; Hormone Replacement Therapy - adverse effects; Humans; Hysterectomy; Neoplasms, Glandular and Epithelial - epidemiology; Neoplasms, Glandular and Epithelial - etiology; Ovarian Neoplasms - epidemiology; Ovarian Neoplasms - etiology; Ovarian Neoplasms - pathology; Pelvic Inflammatory Disease - complications; Pelvic Inflammatory Disease - epidemiology; Protective Factors; Reproductive History; Risk Factors; Sterilization, Tubal; Systematic Reviews, Meta- and Pooled Analyses; Talc - adverse effects; ovarian neoplasms; risk factors; neoplasms; histological type; pelvic inflammatory disease; inflammation
• ISSN: 0002-9262; 1476-6256; 1476-6256
• DOI: 10.1093/aje/kww161

Inflammation has been implicated in ovarian carcinogenesis. However, studies investigating the association between pelvic inflammatory disease (PID) and ovarian cancer risk are few and inconsistent. We investigated the association between PID and the risk of epithelial ovarian cancer according to tumor behavior and histotype. We pooled data from 13 case-control studies, conducted between 1989 and 2009, from the Ovarian Cancer Association Consortium (OCAC), including 9,162 women with ovarian cancers, 2,354 women with borderline tumors, and 14,736 control participants. Study-specific odds ratios were estimated and subsequently combined into a pooled odds ratio using a random-effects model. A history of PID was associated with an increased risk of borderline tumors (pooled odds ratio (pOR) = 1.32, 95% confidence interval (CI): 1.10, 1.58). Women with at least 2 episodes of PID had a 2-fold increased risk of borderline tumors (pOR = 2.14, 95% CI: 1.08, 4.24). No association was observed between PID and ovarian cancer risk overall (pOR = 0.99, 95% CI: 0.83, 1.19); however, a statistically nonsignificantly increased risk of low-grade serous tumors (pOR = 1.48, 95% CI: 0.92, 2.38) was noted. In conclusion, PID was associated with an increased risk of borderline ovarian tumors, particularly among women who had had multiple episodes of PID. Although our results indicated a histotype-specific association with PID, the association of PID with ovarian cancer risk is still somewhat uncertain and requires further investigation.