Person:

Babic, Ana

PURPOSE: Periodontitis, a chronic inflammatory response to pathogenic bacteria in the oral microbiome, is common among adults. It is associated with several medical conditions, including cardiovascular diseases, and potentially with esophageal, lung, oral, and pancreatic cancer. One of the proposed mechanisms behind these associations is systemic inflammation, which has also been implicated in ovarian cancer etiology. The aim of this study was to evaluate association between ovarian cancer and periodontal bone loss. METHODS: The association between periodontal bone loss, a marker of periodontitis, and risk of epithelial ovarian cancer was estimated among 60,560 participants of the prospective Nurses' Health Study using Cox proportional hazards analysis. Competing risks analysis was used to estimate association by histologic subtype. RESULTS: We did not observe an increased risk of ovarian cancer among participants with periodontal bone loss (HR 0.86, 95% CI 0.64-1.15). Among women younger than 69 years, periodontal bone loss was associated with a 40 % (HR 0.60, 95% CI 0.36-0.98) decreased ovarian cancer risk, while there was no association in women older than 69 (HR 1.09, 95% CI 0.75-1.58), although this difference did not reach statistical significance (p-heterogeneity = 0.06). We observed a suggestive decreased risk for serous tumors (HR 0.76, 95% CI 0.53-1.09). The number of natural teeth and root canals, other metrics of oral health, were not associated with ovarian cancer risk. CONCLUSION: Our results do not support an increased ovarian cancer risk in women with periodontal bone loss; however, there was a significant decrease in risk in women younger than 69. Given the unexpected association between periodontal bone loss and ovarian cancer risk in younger women, further research is warranted.

Purpose

Menstrual pain is associated with increased production of inflammatory molecules, such as prostaglandins. Inflammation is involved in pathogenesis of several cancers, including ovarian cancer. In this study we examined the association between menstrual pain and risk of ovarian cancer.

Methods

We conducted a case-control study with 2028 cases of epithelial ovarian cancer, and 2091 age and study center matched controls. Women were asked to report the severity of menstrual pain during their 20s and 30s, when not using oral contraceptives or breastfeeding. We used unconditional logistic regression to evaluate the association between menstrual pain and epithelial ovarian cancer risk overall, and polytomous logistic regression to evaluate whether the association differed across tumor subtypes.

Results

Risk of ovarian cancer was increased in women with moderate (OR=1.22, 95% CI: 1.05–1.42) and severe pain (OR = 1.34, 95% CI: 1.09–1.65) compared to women with no or mild pain during menstrual period. The association differed by histologic subtypes, with significant associations for severe pain with endometrioid (OR = 1.64, 95% CI: 1.15–2.34) and clear cell tumors (OR = 1.91, 95% CI: 1.11–3.28).

Conclusions

Our data suggest that moderate and severe pain during menstrual period is associated with increased risk of epithelial ovarian cancer. Due to high prevalence of menstrual pain in women of reproductive age this observation warrants further studies.

Background: Ovarian cancer survival is poor, particularly for platinum-resistant cases. The previous literature on pre-diagnostic reproductive factors and ovarian cancer survival has been mixed. Therefore, we evaluated pre-diagnostic reproductive and hormonal factors with overall survival and, additionally, platinum-chemotherapy resistance. Methods: We followed 1649 invasive epithelial ovarian cancer cases who were enrolled between 1992 and 2008 for overall mortality within the New England Case-Control Study and abstracted chemotherapy data on a subset (n=449). We assessed pre-diagnostic reproductive and hormonal factors during in-person interviews. We calculated hazard ratios (HRs) using Cox-proportional hazards models. Results: We observed 911 all-cause deaths among 1649 ovarian cancer cases. Self-reported endometriosis and longer duration of hormone therapy use were associated with improved survival (HR: 0.72; 95% confidence interval (CI): 0.54–0.94 and HR, ⩾5 years vs never: 0.70; 95% CI: 0.55–0.90, respectively). Older age at menopause and menarche were associated with worse survival (HR, ⩽50 vs >50 years: 1.23; 95% CI: 1.03–1.46 and HR, 13 vs <13 years: 1.24; 95% CI: 1.06–1.44, respectively). We observed no association between oral contraceptive use, parity and tubal ligation, and overall survival. No significant associations were observed for any of the reproductive and hormonal factors and platinum resistance. Conclusions: These results suggest that pre-diagnostic exposures such as endometriosis and HT use may influence overall survival among ovarian cancer patients.