Author/Authors :
Haem، Elham نويسنده Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran , , Heydari، Seyyed Taghi نويسنده Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran , , Zare، Najaf نويسنده Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran , , B. Lankarani، Kamran نويسنده Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran , , Barooti، Esmat نويسنده MD, Women Health Affairs Office, Ministry of Health and Medical Education, Tehran , , Sharif، Farkhondeh نويسنده Department of Mental Health & Psychiatric Nursing, Faculty of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran ,
Abstract :
Background: This study evaluated the role of family history of cancer and
gynecologic factors in relation to the etiology of ovarian cancer in a low socioeconomic
population in Iran.
Methods: From 2007-2009 we conducted a screening program on women with
insurance coverage provided by the Imam Khomeini Relief Foundation. A total of 26788
women participated in this study of whom 76 cases had ovarian cancer and 26712 were
considered as controls. We used rare event logistic (ReLogit) regression analysis with
a prior correction method that used the Zelig package in R to obtain odds ratio
estimates and confidence intervals.
Results: Ovarian cancer was more frequent among postmenopausal than
premenopausal (odds ratio: 2.30; confidence interval: 1.17-4.49) women. We observed
increased risk for this disease in women with histories of hormone replacement therapy
compared to those with no history (odds ratio: 2.36; confidence interval: 1.13-4.91). A
greater increase in ovarian cancer was observed in women with family histories of breast
(odds ratio: 2.88; confidence interval: 1.44-5.77), ovarian (odds ratio: 11.27; confidence
interval: 5.63-22.54) and all cancer sites (odds ratio: 2.95; confidence interval: 1.71-5.08).
However, the use of oral contraceptive pills was significantly associated with lower risk
for ovarian cancer (odds ratio: 0.47; confidence interval: 0.28-0.79). There was no
association between ovarian cancer and age, marital status, occupation, education level,
age at menarche, age at first pregnancy and number of pregnancies.
Conclusion: Ovarian cancer was considered a rare event. Thus we deemed it
necessary to explore the associated risk factors using ReLogit with a prior correction
method. The risk factors for ovarian cancer were menopause, history of hormone
replacement therapy and family history of cancer of the breast, ovaries and other sites.
Oral use of contraceptive pills showed a protective effect on risk for ovarian cancer.
