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

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

NCI NIH HHS

R01 CA058598

NCI NIH HHS

F31 CA268737

NCI NIH HHS

R01 CA058420

NCI NIH HHS

P30 CA014089

NHLBI NIH HHS

HHSN268201600004C

NCI NIH HHS

R01 CA076016

NHLBI NIH HHS

HHSN268201600001C

NCI NIH HHS

R01 CA207260

NCI NIH HHS

U01 CA164973

NCI NIH HHS

K01 CA212056

NHLBI NIH HHS

75N92021D00002

NCI NIH HHS

UM1 CA173642

NHLBI NIH HHS

HHSN268201600002C

NCI NIH HHS

U01 CA164974

NHLBI NIH HHS

HHSN268201600018C

NCI NIH HHS

UM1 CA164974

NHLBI NIH HHS

HHSN268201600003C

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

NIH NCI

R01-CA61093

NCI

R01-CA17054

NCI

R01-CA58598

Cancer Center Core grant

P30-CA014089

California Cancer Research Program

2II0200

NCI

R01-CA076016

National Heart, Lung, and Blood Institute

HHSN268201600018C

National Heart, Lung, and Blood Institute

HHSN268201600001C

National Heart, Lung, and Blood Institute

HHSN268201600002C

National Heart, Lung, and Blood Institute

HHSN268201600003C

National Heart, Lung, and Blood Institute

HHSN268201600004C

WHI

UM1-CA173642-05

WHI

NHLBI-CSB-WH-2016-01-CM

WHI

NHLBI-75N92021D00002

NCI

F31CA268737