Race Differences in the Associations between Menstrual Cycle Characteristics and Epithelial Ovarian Cancer

Rebecca Nash & Anna H. Wu et al.

Abstract

Background:

Menstrual cycle characteristics—including age at menarche and cycle length— have been associated with ovarian cancer risk in White women. However, the associations between menstrual cycle characteristics and ovarian cancer risk among Black women have been sparsely studied.

Methods:

Using the Ovarian Cancer in Women of African Ancestry (OCWAA) Consortium that includes 1,024 Black and 2,910 White women diagnosed with epithelial ovarian cancer (EOC) and 2,325 Black and 7,549 White matched controls, we investigated associations between menstrual cycle characteristics (age at menarche, age at menstrual regularity, cycle length, and ever missing three periods) and EOC risk by race and menopausal status. Multivariable logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI).

Results:

Black women were more likely to be <11 years at menarche than White women (controls: 9.9% vs. 6.0%). Compared with ≥15 years at menarche, <11 years was associated with increased EOC risk for White (OR = 1.25; 95% CI, 0.99–1.57) but not Black women (OR = 1.10; 95% CI, 0.80–1.55). Among White women only, the association was greater for premenopausal (OR = 2.20; 95% CI, 1.31–3.68) than postmenopausal women (OR = 1.06; 95% CI, 0.82–1.38). Irregular cycle length was inversely associated with risk for White (OR = 0.78; 95% CI, 0.62–0.99) but not Black women (OR = 1.06; 95% CI, 0.68–1.66).

Conclusions:

Earlier age at menarche and cycle irregularity are associated with increased EOC risk for White but not Black women.

Impact:

Associations between menstrual cycle characteristics and EOC risk were not uniform by race.

Funding
Collaborative Genetic Study of Ovarian Cancer RiskMethodological and molecular factors underlying racial disparities in cancer outcomesA Follow-up Study for Causes of Illness in Black WomenCancer Research Training and Education CoordinationNHLBI NIH HHS Grant HHSN268201600004CThe Molecular Epidemiology Of Ovarian CancerNHLBI NIH HHS Grant HHSN268201600001CExploring factors related to racial disparities in ovarian cancer incidence and survival: the OCWAA consortiumUnderstanding Population Differences in Cancer: The MEC StudyAn assessment of whether aspirin and/or vitamin D improves breast cancer outcomes in Black women and the modifying effect of genetic variantsWOMEN'S HEALTH INITIATIVE (WHI) REGIONAL CENTER (RC): TASK AREA A AND A2National Cancer Institute Grant UM1 CA173642NHLBI NIH HHS Grant HHSN268201600002CA Follow-up Study for Causes of Cancer in Black WomenNHLBI NIH HHS Grant HHSN268201600018CA Follow-up Study for Causes of Cancer in Black WomenNHLBI NIH HHS Grant HHSN268201600003CHormone Therapy and Risk of Ovarian CancerEpidemiology of Ovarian Cancer in African-American WomenExploring factors related to racial disparities in ovarian cancer incidence and survival: the OCWAA consortiumAn assessment of whether aspirin and/or vitamin D improves breast cancer outcomes in Black women and the modifying effect of genetic variantsEpidemiology of Ovarian Cancer in African-American WomenA Follow-up Study for Causes of Illness in Black WomenA Follow-up Study for Causes of Cancer in Black WomenA Follow-up Study for Causes of Cancer in Black WomenNIH NCI Grant R01-CA61093Methylation Suicide in Cancer (PQ10)NCI Grant R01-CA58598Leadership, Planning and EvaluationCalifornia Cancer Research Program Grant 2II0200The Molecular Epidemiology Of Ovarian CancerNational Heart, Lung, and Blood Grant HHSN268201600018CNational Heart, Lung, and Blood Grant HHSN268201600001CNational Heart, Lung, and Blood Grant HHSN268201600002CNational Heart, Lung, and Blood Grant HHSN268201600003CNational Heart, Lung, and Blood Grant HHSN268201600004CWHI Grant UM1-CA173642-05WHI Grant NHLBI-CSB-WH-2016-01-CMWHI Grant NHLBI-75N92021D00002Methodological and molecular factors underlying racial disparities in cancer outcomes

NCI NIH HHS

R01 CA058598

NCI NIH HHS

F31 CA268737

NCI NIH HHS

R01 CA058420

NCI NIH HHS

P30 CA014089

NCI NIH HHS

R01 CA076016

NCI NIH HHS

R01 CA207260

NCI NIH HHS

U01 CA164973

NCI NIH HHS

K01 CA212056

NCI NIH HHS

U01 CA164974

NCI NIH HHS

UM1 CA164974

NCI NIH HHS

P01 CA017054

NCI NIH HHS

R01 CA142081

NCI

R01-CA207260

NCI

K01-CA212056

NCI

R01-CA142081

NIH

R01-CA058420

NIH

UM1-CA164974

NIH

U01-CA164974

NCI

R01-CA17054

Cancer Center Core grant

P30-CA014089

NCI

R01-CA076016

NCI

F31CA268737