{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T06:54:29Z","timestamp":1763535269901},"reference-count":29,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,2,19]],"date-time":"2014-02-19T00:00:00Z","timestamp":1392768000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aust NZ J Obst Gynaeco"],"published-print":{"date-parts":[[2014,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Ovarian clear cell carcinoma (<jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content>) is reportedly more common in <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sians than <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>aucasians. We investigated the epidemiology of <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> in an <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sian population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Cases of epithelial ovarian cancer (<jats:styled-content style=\"fixed-case\">EOC<\/jats:styled-content>) diagnosed between <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>anuary 2004 and <jats:styled-content style=\"fixed-case\">D<\/jats:styled-content>ecember 2009 in a gynaecologic oncology unit were studied retrospectively. Patient details and tumour characteristics were retrieved from hospital records and tested for their association with <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> by univariate and binomial logistic regression analysis. A time trend in the proportion of <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> among <jats:styled-content style=\"fixed-case\">EOC<\/jats:styled-content> was computed with data from the <jats:styled-content style=\"fixed-case\">N<\/jats:styled-content>ational <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>ancer <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>egistry of <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ingapore (1968\u20132006).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The institutional cohort of 341 cases included 81 <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> and 260 non\u2010<jats:styled-content style=\"fixed-case\">OCCC EOC<\/jats:styled-content>. Independent risk factors for <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> were nulliparity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.36) and endometriosis (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a04.87). Compared with other <jats:styled-content style=\"fixed-case\">EOC<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> OCCC<\/jats:styled-content> was significantly larger in tumour size (13.5 vs. 11.3\u00a0cm), more frequently located unilaterally (84.3 vs. 65.5%), diagnosed at <jats:styled-content style=\"fixed-case\">FIGO<\/jats:styled-content> stage\u20101 (63.0 vs. 33.9%) and negative for serum <jats:styled-content style=\"fixed-case\">CA<\/jats:styled-content>125 (34.2 vs. 8.2%), and less often (53 vs. 85%) associated with a positive <jats:styled-content style=\"fixed-case\">R<\/jats:styled-content>isk of <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>alignancy <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>ndex. Nation\u2010wide statistics revealed a steady increase in the proportion of <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> among <jats:styled-content style=\"fixed-case\">EOC<\/jats:styled-content> from 5.2 to 13.4% between 1968 and 2006. The frequency of <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ingapore was higher than <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican <jats:styled-content style=\"fixed-case\">W<\/jats:styled-content>hites, similar to <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>merican <jats:styled-content style=\"fixed-case\">A<\/jats:styled-content>sians but lower than <jats:styled-content style=\"fixed-case\">J<\/jats:styled-content>apanese.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The difference in epidemiologic and tumour characteristics between <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> and other <jats:styled-content style=\"fixed-case\">EOC<\/jats:styled-content> was nondiscriminatory. Three distinct ethnic\u2010related clusters of frequency distribution globally and the rising trend in proportion of <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>ingapore suggested that ethnic\u2013genetic predisposition and economy\u2010related environmental factors contributed to development of <jats:styled-content style=\"fixed-case\">OCCC<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ajo.12188","type":"journal-article","created":{"date-parts":[[2014,2,20]],"date-time":"2014-02-20T10:45:34Z","timestamp":1392893134000},"page":"225-230","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Evidence for ethnic and environmental contributions to frequency of ovarian clear cell carcinoma"],"prefix":"10.1111","volume":"54","author":[{"given":"Sun Kuie","family":"Tay","sequence":"first","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Singapore General Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"May Anne","family":"Cheong","sequence":"additional","affiliation":[{"name":"Department of Obstetrics &amp; Gynaecology Singapore General Hospital Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,2,19]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19810315)47:6<1344::AID-CNCR2820470618>3.0.CO;2-3"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(89)90852-4"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1996.0065"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20000601)88:11<2584::AID-CNCR22>3.0.CO;2-5"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1995.1027"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(89)90043-7"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1998.5071"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.05.025"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/09513590902770131"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.02.006"},{"key":"e_1_2_6_12_1","unstructured":"Trends in Cancer Incidence in Singapore 1968\u20132002. 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