Victoria Do

October 5, 2015
Biol 4330
Dr. Gupta
Cigarette Smoking and Risk of Ovarian Cancer:
A pooled analysis of 21 Case Control Studies
Cancer has been a global health issue that affects millions of people across the world. It
can start almost anywhere in the human body and can be caused by many different factors. One
common cancer amongst women in the Western world is ovarian cancer. Ovarian cancer is the
sixth most common cancer diagnosed and the sixth leading cause of cancer death (pg. 5). Many
studies has assessed cigarette smoking as a potential risk factor for ovarian cancer. To further
assess the association between cigarette smoking and ovarian cancer, the article explains the data
that was used from 21 recent case-control studies associated with the Ovarian Cancer
Association Consortium.
In the past, majority of previous studies have observed an increased risk of mucinous
ovarian tumors associated with cigarette smoking, but the association with other histological
types is unclear. But recently, a large meta-analysis conducted by the Collaborative Group on
Epidemiological Studies of Ovarian Cancer found that current smoking increased the risk of
invasive and borderline mucinous ovarian tumors (pg.6). So in a large pooled analysis, they
examined the risk of epithelial ovarian cancer associated with multiple measures of cigarette
smoking with a focus on characterizing risks according to tumor behavior and histology.
To go fourth with the data analysis, they obtained data from twenty one case-control
studies of ovarian cancer from the OCAC (19,066 controls, 11,972 invasive and 2,752 borderline
cases). Study-specific odds ratios and 95% confidence intervals were also obtained from logistic
regression models and combined into a pooled odds ratio using a random effects model (pg.5).
Information on the following variables were also documented and analyzed: smoking status,

cigarette consumption, total duration of smoking, age at smoking initiation, and time since
smoking cessation. For results to be recorded, tumor behaviors and smoking status had to be
grouped and categorized.
According to the data analysis, among the 11,972 woman with invasive ovarian cancer,
never smokers comprised 54.7% whereas former and current smokers constituted 31.8% and
13.6%. For the 2.752 women with borderline ovarian tumors, 48.2% were never smokers, 29.9%
were former, and 21.9% current smokers. And lastly, among the 19,066 control women, 52.8%
were never smokers, 31.0% were former, and 16.3% were current smokers. They found no
association between cigarette smoking and overall invasive ovarian cancer risk, either for current
or for former smokers.
Based on the study, cigarette is a risk factor for some cases of ovarian cancer but not all.
Current cigarette smoking increased the risk of invasive mucinous and borderline mucinous
ovarian cancer tumors, while former smoking increased the risk of borderline serous ovarian
tumors. For these histological types, consistent dose response associations were observed. No
convincing associations between smoking and risk of invasive serous and endometriod ovarian
cancer were observed, while it did provide some evidence of decreased risk of invasive clear cell
ovarian cancer (pg.8).
The purpose of this study was to examine the association between cigarette smoking and
ovarian cancer risk according to tumor histology and behavior. Overall, the results revealed some
differences in the risk profiles of histological types of ovarian cancer with regard to cigarette
smoking. Moderate increases in risk of invasive and borderline mucinous tumors and borderline
serous tumors associated with cigarette smoking. Also based on the findings, the different
etiologies of the histological types may add to the fact that ovarian cancer is a heterogeneous
disease.