Race Differences in the Associations between Menstrual Cycle Characteristics and Epithelial Ovarian Cancer

• Type of Material: Article
• Authors: Rebecca Nash, Emory University; Courtney E Johnson, Emory University; Holly R Harris, Fred Hutchinson Cancer Research Center; Lauren C Peres, H. Lee Moffitt Cancer Center and Research Institute; Charlotte E Joslin, University of Illinois at Chicago; Traci N Bethea, Georgetown University; Elisa Bandera, Rutgers Cancer Institute of New Jersey; Heather M Ochs-Balcom, University at Buffalo, The State University of New York; Evan R Myers, Duke University; Kristin A Guertin, University of Virginia; Fabian Camacho, University of Virginia; Alicia Beeghly-Fadiel, Vanderbilt University; Patricia G Moorman, Duke University; Veronica W Setiawan, University of Southern California; Lynn Rosenberg, Boston University; Joellen Schildkraut, Emory University; Anna H Wu, University of Southern California
• Language: English
• Date: 2022-08-01
• Publisher: AMER ASSOC CANCER RESEARCH
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2022, American Association for Cancer Research
• Final Published Version (URL): http://dx.doi.org/10.1158/1055-9965.EPI-22-0115
• Title of Journal or Parent Work: CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
• Volume: 31
• Issue: 8
• Start Page: 1610
• End Page: 1620
• Grant/Funding Information: The Ovarian Cancer in Women of African Ancestry (OCWAA) Consortium is supported by the US National Cancer Institute (R01-CA207260, to J.M. Schildkraut and L. Rosenberg and K01-CA212056, to T.N. Bethea). AACES was funded by NCI (R01-CA142081, to J.M. Schildkraut); BWHS is funded by NIH (R01-CA058420, UM1-CA164974, and U01-CA164974, to L. Rosenberg); CCCS was funded by NIH/NCI (R01-CA61093, to K. Rosenblatt); LACOCS was funded by NCI (R01-CA17054, to M. Pike, R01-CA58598, to M. Goodman and A.H. Wu, and Cancer Center Core grant P30-CA014089, to B. Henderson and A.H. Wu) and by the California Cancer Research Program (2II0200, to A.H. Wu); and NCOCS was funded by NCI (R01-CA076016, to J.M. Schildkraut). The WHI program is funded by the National Heart, Lung, and Blood Institute through contracts HHSN268201600018C, HHSN268201600001C, HHSN268201600002C, HHSN268201600003C, and HHSN268201600004C. Additional grants to support WHI inclusion in OCWAA include UM1-CA173642-05 (to Anderson), NHLBI-CSB-WH-2016-01-CM, and NHLBI-75N92021D00002. R Nash is additionally supported by an award from the US National Cancer Institute (F31CA268737).
• Keywords: Science & Technology; NATURAL MENOPAUSE; Oncology; INCESSANT OVULATION; AMP Exception; MENARCHE; AGE; AFRICAN-AMERICAN; Public, Environmental & Occupational Health; LOS-ANGELES; COLLABORATIVE ANALYSIS; Life Sciences & Biomedicine; STEROID-HORMONES; RISK-FACTORS; REPRODUCTIVE FACTORS

Abstract

Background: Menstrual cycle characteristics-including age at menarche and cycle length- have been associated with ovarian cancer risk in White women. However, the associations between menstrual cycle characteristics and ovarian cancer risk among Black women have been sparsely studied. Methods: Using the Ovarian Cancer in Women of African Ancestry (OCWAA) Consortium that includes 1,024 Black and 2,910 White women diagnosed with epithelial ovarian cancer (EOC) and 2,325 Black and 7,549 White matched controls, we investigated associations between menstrual cycle characteristics (age at menarche, age at menstrual regularity, cycle length, and ever missing three periods) and EOC risk by race and menopausal status. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Results: Black women were more likely to be <11 years at menarche than White women (controls: 9.9% vs. 6.0%). Compared with ≥15 years at menarche, <11 years was associated with increased EOC risk for White (OR ¼ 1.25; 95% CI, 0.99-1.57) but not Black women (OR ¼ 1.10; 95% CI, 0.80-1.55). Among White women only, the association was greater for premenopausal (OR ¼ 2.20; 95% CI, 1.31-3.68) than postmenopausal women (OR ¼ 1.06; 95% CI, 0.82-1.38). Irregular cycle length was inversely associated with risk for White (OR ¼ 0.78; 95% CI, 0.62-0.99) but not Black women (OR ¼ 1.06; 95% CI, 0.68-1.66). Conclusions: Earlier age at menarche and cycle irregularity are associated with increased EOC risk for White but not Black women. Impact: Associations between menstrual cycle characteristics and EOC risk were not uniform by race.