Cardiometabolic comorbidities and epithelial ovarian cancer risk among African-American women in the African-American Cancer Epidemiology Study (AACES)

• Type of Material: Article
• Authors: Jeanine N Staples, University of Virginia; Lauren C Peres, H Lee Moffitt Cancer Centre & Research Institute; Fabian Camacho, University of Virginia; Anthony J Alberg, University of South Carolina; Elisa Bandera, Rutgers Cancer Institute of New Jersey; Jill Barnholtz-Sloan, Case Western Reserve University; Melissa L Bondy, Baylor College of Medicine; Michele L Cote, Wayne State University; Ellen Funkhouser, University of Alabama Birmingham; Patricia G Moorman, Duke University; Edward S Peters, Louisiana State University; Ann G Schwartz, Wayne State University; Paul D Terry, University of Tennessee Medical Center; Joellen Schildkraut, Emory University
• Language: English
• Date: 2020-07-01
• Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2020 Published by Elsevier Inc.
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ygyno.2020.04.700
• Title of Journal or Parent Work: GYNECOLOGIC ONCOLOGY
• Volume: 158
• Issue: 1
• Start Page: 123
• End Page: 129
• Grant/Funding Information: The AACES study was funded by NCI (CA142081-01A1). Additional support was provided by Metropolitan Detroit Cancer Surveillance System (MDCSS) with federal funds from the National Cancer Institute, National Institute of Health, Dept. of Health and Human Services, under Contract No. HHSN261201000028C and the Epidemiology Research Core, supported in part by NCI Center Grant (P30CA22453) to the Karmanos Cancer Institute, Wayne State University School of Medicine.
• Keywords: STATINS; SURVIVAL; IMPACT; Disparities; CHOLESTEROL; DRUG; Life Sciences & Biomedicine; Ovarian cancer risk; Science & Technology; Cardiovascular disease; HYPERTENSION; BIOMARKER; Oncology; BETA-BLOCKERS; METFORMIN; PROGRESSION; Obstetrics & Gynecology

Abstract

Background: Studies that have examined the association between cardiovascular comorbidities and epithelial ovarian cancer (EOC) have yielded inconsistent results. It remains unknown whether cardiometabolic disease is associated with EOC in African American (AA) women, who have a higher prevalence of cardiovascular disease and lower risk of EOC than White women. Here, we estimate the effect of cardiovascular comorbid conditions and EOC risk among AA women. Methods: Data were available from 593 ovarian carcinoma patients and 752 controls enrolled in the African American Cancer Epidemiology Study (AACES). Participants were asked to self-report a history of hypertension, hyperlipidemia, and diabetes and any current medication use. The relationship between hypertension, hyperlipidemia, diabetes, and medications taken for these conditions was determined using multivariate logistic regression. Results: Hypertension was associated with an increased risk (adjusted odds ratio (aOR) = 1.32, 95% confidence interval (CI) = 1.01, 1.73), whereas diabetes and hyperlipidemia were associated with a decreased risk (aOR = 0.67, 95% CI = 0.49, 0.91 and aOR = 0.61, 95% CI = 0.47, 0.80, respectively) of EOC. Use of anti-diabetic medication was inversely associated with EOC risk, as was use of lipid lowering medications (in the overall study population), which were predominantly statins. Among women with hypertension, use of anti-hypertensive medications was inversely associated with EOC risk, with associations that were most pronounced for diuretics, ARBs and ACE inhibitors. Conclusion: Hypertension was associated with an increased EOC risk in this patient population, whereas an inverse association was observed for diabetes and hyperlipidemia. The decreased risk of EOC identified with use of anti-hypertensive, anti-diabetes or lipid-lowering medications could have implications for risk reduction strategies.