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Association between genetically predicted polycystic ovary syndrome and ovarian cancer: a Mendelian randomization study.
Int J Epidemiol 2019; 48(3):822-830IJ

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) is a complex endocrine disorder with an estimated prevalence of 4-21% in reproductive aged women. Recently, the Ovarian Cancer Association Consortium (OCAC) reported a decreased risk of invasive ovarian cancer among women with self-reported PCOS. However, given the limitations of self-reported PCOS, the validity of these observed associations remains uncertain. Therefore, we sought to use Mendelian randomization with genetic markers as a proxy for PCOS, to examine the association between PCOS and ovarian cancer.

METHODS

Utilizing 14 single nucleotide polymorphisms (SNPs) previously associated with PCOS we assessed the association between genetically predicted PCOS and ovarian cancer risk, overall and by histotype, using summary statistics from a previously conducted genome-wide association study (GWAS) of ovarian cancer among European ancestry women within the OCAC (22 406 with invasive disease, 3103 with borderline disease and 40 941 controls).

RESULTS

An inverse association was observed between genetically predicted PCOS and invasive ovarian cancer risk: odds ratio (OR)=0.92 [95% confidence interval (CI)=0.85-0.99; P = 0.03]. When results were examined by histotype, the strongest inverse association was observed between genetically predicted PCOS and endometrioid tumors (OR = 0.77; 95% CI = 0.65-0.92; P = 0.003). Adjustment for individual-level body mass index, oral contraceptive use and parity did not materially change the associations.

CONCLUSION

Our study provides evidence for a relationship between PCOS and reduced ovarian cancer risk, overall and among specific histotypes of invasive ovarian cancer. These results lend support to our previous observational study results. Future studies are needed to understand mechanisms underlying this association.

Authors+Show Affiliations

Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA.Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia. School of Public Health, University of Queensland, Herston, Queensland, Australia.Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia. School of Public Health, University of Queensland, Herston, Queensland, Australia.Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia. School of Public Health, University of Queensland, Herston, Queensland, Australia.No affiliation info availableDepartment of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA.Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.Caner Prevention and Genetics Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Department of Biomedical Sciences, Community and Population Health Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.The University of Texas School of Public Health, Houston, TX, USA.Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark. Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.Department of Public Health Sciences, The University of Virginia, Charlottesville, VA, USA.Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.Division of Obstetrics and Gynecology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.Division of Obstetrics and Gynecology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.Epidemiology Division, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada.Epidemiology Division, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada.Public Health Ontario, Samuel Lunenfeld Research Institute, Toronto, Canada.Department of Medicine, University of California Irvine, Irvine, CA, USA.Department of Medicine, University of California Irvine, Irvine, CA, USA.Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA. Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA. Department of Epidemiology, University of Washington, Seattle, WA, USA.Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31211375

Citation

Harris, Holly R., et al. "Association Between Genetically Predicted Polycystic Ovary Syndrome and Ovarian Cancer: a Mendelian Randomization Study." International Journal of Epidemiology, vol. 48, no. 3, 2019, pp. 822-830.
Harris HR, Cushing-Haugen KL, Webb PM, et al. Association between genetically predicted polycystic ovary syndrome and ovarian cancer: a Mendelian randomization study. Int J Epidemiol. 2019;48(3):822-830.
Harris, H. R., Cushing-Haugen, K. L., Webb, P. M., Nagle, C. M., Jordan, S. J., Risch, H. A., ... Terry, K. L. (2019). Association between genetically predicted polycystic ovary syndrome and ovarian cancer: a Mendelian randomization study. International Journal of Epidemiology, 48(3), pp. 822-830. doi:10.1093/ije/dyz113.
Harris HR, et al. Association Between Genetically Predicted Polycystic Ovary Syndrome and Ovarian Cancer: a Mendelian Randomization Study. Int J Epidemiol. 2019 Jun 1;48(3):822-830. PubMed PMID: 31211375.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association between genetically predicted polycystic ovary syndrome and ovarian cancer: a Mendelian randomization study. AU - Harris,Holly R, AU - Cushing-Haugen,Kara L, AU - Webb,Penelope M, AU - Nagle,Christina M, AU - Jordan,Susan J, AU - ,, AU - Risch,Harvey A, AU - Rossing,Mary Anne, AU - Doherty,Jennifer A, AU - Goodman,Marc T, AU - Modugno,Francesmary, AU - Ness,Roberta B, AU - Moysich,Kirsten B, AU - Kjær,Susanne K, AU - Høgdall,Estrid, AU - Jensen,Allan, AU - Schildkraut,Joellen M, AU - Berchuck,Andrew, AU - Cramer,Daniel W, AU - Bandera,Elisa V, AU - Rodriguez,Lorna, AU - Wentzensen,Nicolas, AU - Kotsopoulos,Joanne, AU - Narod,Steven A, AU - McLaughlin,John R, AU - Anton-Culver,Hoda, AU - Ziogas,Argyrios, AU - Pearce,Celeste L, AU - Wu,Anna H, AU - Lindström,Sara, AU - Terry,Kathryn L, PY - 2019/05/23/accepted PY - 2019/6/19/pubmed PY - 2019/6/19/medline PY - 2019/6/19/entrez KW - Mendelian randomization KW - Polycystic ovary syndrome KW - histotype KW - ovarian cancer SP - 822 EP - 830 JF - International journal of epidemiology JO - Int J Epidemiol VL - 48 IS - 3 N2 - BACKGROUND: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder with an estimated prevalence of 4-21% in reproductive aged women. Recently, the Ovarian Cancer Association Consortium (OCAC) reported a decreased risk of invasive ovarian cancer among women with self-reported PCOS. However, given the limitations of self-reported PCOS, the validity of these observed associations remains uncertain. Therefore, we sought to use Mendelian randomization with genetic markers as a proxy for PCOS, to examine the association between PCOS and ovarian cancer. METHODS: Utilizing 14 single nucleotide polymorphisms (SNPs) previously associated with PCOS we assessed the association between genetically predicted PCOS and ovarian cancer risk, overall and by histotype, using summary statistics from a previously conducted genome-wide association study (GWAS) of ovarian cancer among European ancestry women within the OCAC (22 406 with invasive disease, 3103 with borderline disease and 40 941 controls). RESULTS: An inverse association was observed between genetically predicted PCOS and invasive ovarian cancer risk: odds ratio (OR)=0.92 [95% confidence interval (CI)=0.85-0.99; P = 0.03]. When results were examined by histotype, the strongest inverse association was observed between genetically predicted PCOS and endometrioid tumors (OR = 0.77; 95% CI = 0.65-0.92; P = 0.003). Adjustment for individual-level body mass index, oral contraceptive use and parity did not materially change the associations. CONCLUSION: Our study provides evidence for a relationship between PCOS and reduced ovarian cancer risk, overall and among specific histotypes of invasive ovarian cancer. These results lend support to our previous observational study results. Future studies are needed to understand mechanisms underlying this association. SN - 1464-3685 UR - https://www.unboundmedicine.com/medline/citation/31211375/Association_between_genetically_predicted_polycystic_ovary_syndrome_and_ovarian_cancer:_a_Mendelian_randomization_study_ L2 - https://academic.oup.com/ije/article-lookup/doi/10.1093/ije/dyz113 DB - PRIME DP - Unbound Medicine ER -