Pelvic Inflammatory Disease and the Risk of Ovarian Cancer and Borderline Ovarian Tumors: A Pooled Analysis of 13 Case-Control Studies.
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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, , on behalf of the Ovarian Cancer Association Consortium
Аннотация
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.