{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:40:26Z","timestamp":1790052026944,"version":"4.0.1"},"reference-count":25,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,2,26]],"date-time":"2015-02-26T00:00:00Z","timestamp":1424908800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:p>Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (<jats:italic>i.e<\/jats:italic>., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone\u2010related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone\u2010related risk factors (follow\u2010up: 1992\u20132010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (<jats:italic>i.e<\/jats:italic>., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] <jats:italic>vs<\/jats:italic>. type II [high grade serous or endometrioid]) for full\u2010term pregnancy (<jats:italic>p<\/jats:italic><jats:sub>het<\/jats:sub>\u2009=\u20090.02). Full\u2010term pregnancy was more strongly inversely associated with type I than type II tumors (ever <jats:italic>vs<\/jats:italic>. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33\u20130.69]; type II, RR: 0.81 [0.61\u20131.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (<jats:italic>e.g<\/jats:italic>., ever full\u2010term pregnancy: serous, RR: 0.73 [0.58\u20130.92]; mucinous, RR: 0.53 [0.30\u20130.95]; endometrioid, RR: 0.65 [0.40\u20131.06]; clear cell, RR: 0.34 [0.18\u20130.64]; <jats:italic>p<\/jats:italic><jats:sub>het<\/jats:sub>\u2009=\u20090.16). These results suggest limited heterogeneity between reproductive and hormone\u2010related risk factors and EOC subtypes.<\/jats:p>","DOI":"10.1002\/ijc.29471","type":"journal-article","created":{"date-parts":[[2015,2,6]],"date-time":"2015-02-06T02:16:40Z","timestamp":1423189000000},"page":"1196-1208","source":"Crossref","is-referenced-by-count":57,"title":["Reproductive and hormone\u2010related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort"],"prefix":"10.1002","volume":"137","author":[{"given":"Ren\u00e9e T.","family":"Fortner","sequence":"first","affiliation":[{"name":"Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Ose","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa A.","family":"Merritt","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Imperial College London London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Schock","sequence":"additional","affiliation":[{"name":"Division of Cancer Epidemiology German Cancer Research Center (DKFZ) Heidelberg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Tj\u00f8nneland","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Hansen","sequence":"additional","affiliation":[{"name":"Danish Cancer Society Research Center Copenhagen Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Overvad","sequence":"additional","affiliation":[{"name":"Department of Public Health Aarhus University Section for Epidemiology Aarhus Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laure","family":"Dossus","sequence":"additional","affiliation":[{"name":"U1018, Nutrition, Hormones and Women's Health Team Inserm, Centre for Research in Epidemiology and Population Health (CESP) Villejuif France"},{"name":"Universit\u00e9 Paris Sud, Unit\u00e9 Mixte de Recherche Scientifique 1018 Villejuif France"},{"name":"U1018, Nutrition, Hormones and Women's Health Team Institut Gustave Roussy Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7oise","family":"Clavel\u2010Chapelon","sequence":"additional","affiliation":[{"name":"U1018, Nutrition, Hormones and Women's Health Team Inserm, Centre for Research in Epidemiology and Population Health (CESP) Villejuif France"},{"name":"Universit\u00e9 Paris Sud, Unit\u00e9 Mixte de Recherche Scientifique 1018 Villejuif France"},{"name":"U1018, Nutrition, Hormones and Women's Health Team Institut Gustave Roussy Villejuif France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Baglietto","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Centre, Cancer Council of Victoria Melbourne Australia"},{"name":"Centre for Epidemiology and Biostatistics, School of Population and Global Health University of Melbourne  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heiner","family":"Boeing","sequence":"additional","affiliation":[{"name":"Department of Epidemiology German Institute of Human Nutrition (DIfE) Potsdam\u2010Rehbr\u00fccke Nuthetal Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonia","family":"Trichopoulou","sequence":"additional","affiliation":[{"name":"Hellenic Health Foundation Athens 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MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Agnoli","sequence":"additional","affiliation":[{"name":"Epidemiology and Prevention Unit Fondazione IRCCS Istituto Nazionale Dei Tumori Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amalia","family":"Mattiello","sequence":"additional","affiliation":[{"name":"Dipartimento Di Medicina Clinica E Chirurgia, Federco II University Naples Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Masala","sequence":"additional","affiliation":[{"name":"Molecular and Nutritional Epidemiology Unit Cancer Research and Prevention Institute\u2014ISPO Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosario","family":"Tumino","sequence":"additional","affiliation":[{"name":"Cancer Registry and Histopathology Unit \u201cCivic\u2014M.P. Arezzo\u201d Hospita Ragusa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Sacerdote","sequence":"additional","affiliation":[{"name":"Unit of Cancer Epidemiology, AO Citta' Della Salute E Della Scienza\u2010University of Turin and Center for Cancer Prevention (CPO) Turin Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.B(as)","family":"Bueno\u2010de\u2010Mesquita","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, School of Public Health Imperial College London London United Kingdom"},{"name":"Department for Determinants of Chronic Diseases (DCD) National Institute for Public Health and the Environment (RIVM) Bilthoven The Netherlands"},{"name":"Department of Gastroenterology and Hepatology University Medical Centre Utrecht The Netherlands"},{"name":"Department of Social and Preventive Medicine, Faculty of Medicine University of Malaya Kuala Lumpur Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. 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