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abstract
Background: In U.S. women, lifetime risk of ovarian cancer is 1.37%, but some women are at a substantially lower or higher risk than
this average.
Methods: We have
characterized the distribution of lifetime risk in the general
population. Published data on the relative risks and
their variances for five well-accepted risk and
protective factors for ovarian cancer, oral contraceptive use, parity,
tubal
ligation, endometriosis, and first-degree family
history of ovarian cancer in conjunction with a genetic risk score using
genome-wide significant common, low penetrance
variants were used. The joint distribution of these factors (i.e.,
risk/protective
factor profiles) was derived using control data
from four U.S. population–based studies, providing a broad
representation
of women in the United States.
Results: A total of 214
combinations of risk/protective factors were observed, and the lifetime
risk estimates ranged from 0.35% [95%
confidence interval (CI), 0.29–0.42] to 8.78% (95%
CI, 7.10–10.9). Among women with lifetime risk ranging from 4% to 9%,
73%
had no family history of ovarian cancer; most of
these women had a self-reported history of endometriosis.
Conclusions: Profiles
including the known modifiable protective factors of oral contraceptive
use and tubal ligation were associated with
a lower lifetime risk of ovarian cancer. Oral
contraceptive use and tubal ligation were essentially absent among the
women
at 4% to 9% lifetime risk.
Impact: This work
demonstrates that there are women in the general population who have a
much higher than average lifetime risk of
ovarian cancer. Preventive strategies are
available. Should effective screening become available, higher than
average risk
women can be identified. Cancer Epidemiol Biomarkers Prev; 24(4); 671–6. ©2015 AACR.
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