Bone Fractures and Incident Epithelial Ovarian Cancer in a Prospective Cohort Study

Overview

Journal J Womens Health (Larchmt)

Specialty Gynecology & Obstetrics

Date 2009 Dec 3

PMID 19951211

Citations 2

Authors

Kim N Danforth

Catherine Schairer

Arthur Schatzkin

James V Lacey

Affiliations

Soon will be listed here.

Abstract

Objective: Osteoporosis and osteoporotic fractures are hypothesized to reflect circulating hormone levels in older women and have been inversely associated with breast and endometrial cancers. However, associations between fractures and ovarian cancer, another hormonal cancer, have not been examined. Therefore, we conducted a prospective study among women in the Breast Cancer Detection Demonstration Project Follow-up Study.

Methods: Fractures after age 45 were assessed using two questionnaires from 1987 to 1995. Relative risks (RRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models, adjusting for potential confounders. Fracture location was used to further evaluate the fractures most likely to be osteoporotic.

Results: Among 36,115 women with up to 11 years of follow-up (average follow-up was 8.3 years), there were 151 cases of incident ovarian cancer. Fractures were reported by 19% (n = 6,919) of women. Ovarian cancer risk was not associated with any (RR = 1.13, 95% CI 0.74-1.71) or likely osteoporotic (RR = 1.05, 95% CI 0.65-1.69) fractures. Among never users of postmenopausal hormones, the association between any fracture and ovarian cancer (RR = 1.21, 95% CI 0.55-2.65, n = 50 cases) also was statistically nonsignificant.

Conclusions: Data from this large, prospective study do not support an association between fractures and ovarian cancer risk.

Citing Articles

Exploring estrogen-related mechanisms in ovarian carcinogenesis: association between bone mineral density and ovarian cancer risk in a multivariable Mendelian randomization study.

Tuesley K, Webb P, Protani M, Donovan P, Jordan S, Dixon-Suen S Cancer Causes Control. 2024; 36(2):171-182.

PMID: 39419895 PMC: 11775049. DOI: 10.1007/s10552-024-01926-9.

Nitrogen-based Bisphosphonate Use and Ovarian Cancer Risk in Women Aged 50 Years and Older.

Tuesley K, Webb P, Protani M, Spilsbury K, Pearson S, Coory M J Natl Cancer Inst. 2022; 114(6):878-884.

PMID: 35262727 PMC: 9194625. DOI: 10.1093/jnci/djac050.

Postmenopausal Fracture History and Survival After Reproductive Cancer Diagnosis.

Newcomb P, Adams S, Mayer S, Passarelli M, Tinker L, Lane D JNCI Cancer Spectr. 2019; 2(1):pky001.

PMID: 31355356 PMC: 6643753. DOI: 10.1093/jncics/pky001.

References

. Hormone therapy for the prevention of chronic conditions in postmenopausal women: recommendations from the U.S. Preventive Services Task Force. Ann Intern Med. 2005; 142(10):855-60. View

Key T, Verkasalo P, Banks E . Epidemiology of breast cancer. Lancet Oncol. 2002; 2(3):133-40. DOI: 10.1016/S1470-2045(00)00254-0. View

Richelson L, Wahner H, Melton 3rd L, Riggs B . Relative contributions of aging and estrogen deficiency to postmenopausal bone loss. N Engl J Med. 1984; 311(20):1273-5. DOI: 10.1056/NEJM198411153112002. View

Persson I, Adami H, McLaughlin J, Naessen T, Fraumeni Jr J . Reduced risk of breast and endometrial cancer among women with hip fractures (Sweden). Cancer Causes Control. 1994; 5(6):523-8. DOI: 10.1007/BF01831380. View

Ozdemir F, Demirbag D, Rodoplu M . Reproductive factors affecting the bone mineral density in postmenopausal women. Tohoku J Exp Med. 2005; 205(3):277-85. DOI: 10.1620/tjem.205.277. View

Melton 3rd L, Achenbach S, Gebhart J, Babalola E, Atkinson E, Bharucha A . Influence of hysterectomy on long-term fracture risk. Fertil Steril. 2007; 88(1):156-62. PMC: 2032011. DOI: 10.1016/j.fertnstert.2006.11.080. View

Doherty D, Sanders K, Kotowicz M, Prince R . Lifetime and five-year age-specific risks of first and subsequent osteoporotic fractures in postmenopausal women. Osteoporos Int. 2001; 12(1):16-23. DOI: 10.1007/s001980170152. View

Lubin J, Gail M . On power and sample size for studying features of the relative odds of disease. Am J Epidemiol. 1990; 131(3):552-66. DOI: 10.1093/oxfordjournals.aje.a115530. View

Lane N . Epidemiology, etiology, and diagnosis of osteoporosis. Am J Obstet Gynecol. 2006; 194(2 Suppl):S3-11. DOI: 10.1016/j.ajog.2005.08.047. View

10.

Olsen C, Green A, Whiteman D, Sadeghi S, Kolahdooz F, Webb P . Obesity and the risk of epithelial ovarian cancer: a systematic review and meta-analysis. Eur J Cancer. 2007; 43(4):690-709. DOI: 10.1016/j.ejca.2006.11.010. View

11.

Folsom A, Anderson J, Ross J . Estrogen replacement therapy and ovarian cancer. Epidemiology. 2004; 15(1):100-4. DOI: 10.1097/01.ede.0000091606.31903.8e. View

12.

Baker L . Breast Cancer Detection Demonstration Project: five-year summary report. CA Cancer J Clin. 1982; 32(4):194-225. DOI: 10.3322/canjclin.32.4.194. View

13.

Newcomb P, Trentham-Dietz A, Egan K, Titus-Ernstoff L, Baron J, Storer B . Fracture history and risk of breast and endometrial cancer. Am J Epidemiol. 2001; 153(11):1071-8. DOI: 10.1093/aje/153.11.1071. View

14.

Garcia-Closas M, Lubin J . Power and sample size calculations in case-control studies of gene-environment interactions: comments on different approaches. Am J Epidemiol. 1999; 149(8):689-92. DOI: 10.1093/oxfordjournals.aje.a009876. View

15.

Fox K, Magaziner J, Sherwin R, Scott J, Plato C, Nevitt M . Reproductive correlates of bone mass in elderly women. Study of Osteoporotic Fractures Research Group. J Bone Miner Res. 1993; 8(8):901-8. DOI: 10.1002/jbmr.5650080802. View

16.

Kanis J, Oden A, Johnell O, Jonsson B, De Laet C, Dawson A . The burden of osteoporotic fractures: a method for setting intervention thresholds. Osteoporos Int. 2001; 12(5):417-27. DOI: 10.1007/s001980170112. View

17.

Purdie D, Green A . Epidemiology of endometrial cancer. Best Pract Res Clin Obstet Gynaecol. 2001; 15(3):341-54. DOI: 10.1053/beog.2000.0180. View

18.

Helzlsouer K, Alberg A, Gordon G, Longcope C, Bush T, Hoffman S . Serum gonadotropins and steroid hormones and the development of ovarian cancer. JAMA. 1995; 274(24):1926-30. View

19.

Lukanova A, Lundin E, Akhmedkhanov A, Micheli A, Rinaldi S, Zeleniuch-Jacquotte A . Circulating levels of sex steroid hormones and risk of ovarian cancer. Int J Cancer. 2003; 104(5):636-42. DOI: 10.1002/ijc.10990. View

20.

Cummings S, Browner W, Bauer D, Stone K, Ensrud K, Jamal S . Endogenous hormones and the risk of hip and vertebral fractures among older women. Study of Osteoporotic Fractures Research Group. N Engl J Med. 1998; 339(11):733-8. DOI: 10.1056/NEJM199809103391104. View