Association between genetically predicted polycystic ovary syndrome and ovarian cancer: a Mendelian randomization study

Holly R Harris; Kara L Cushing-Haugen; Penelope M Webb; Christina M Nagle; Susan J Jordan; Australian Ovarian Cancer Study Group; Harvey A Risch; Mary Anne Rossing; Jennifer A Doherty; Marc T Goodman; Francesmary Modugno; Roberta B Ness; Kirsten B Moysich; Susanne K Kjær; Estrid Høgdall; Allan Jensen; Joellen M Schildkraut; Andrew Berchuck; Daniel W Cramer; Elisa V Bandera; Lorna Rodriguez; Nicolas Wentzensen; Joanne Kotsopoulos; Steven A Narod; John R McLaughlin; Hoda Anton-Culver; Argyrios Ziogas; Celeste L Pearce; Anna H Wu; Sara Lindström; Kathryn L Terry

doi:10.1093/ije/dyz113

Association between genetically predicted polycystic ovary syndrome and ovarian cancer: a Mendelian randomization study

Int J Epidemiol. 2019 Jun 1;48(3):822-830. doi: 10.1093/ije/dyz113.

Authors

Holly R Harris^{1

2}, Kara L Cushing-Haugen¹, Penelope M Webb^{3

4}, Christina M Nagle^{3

4}, Susan J Jordan^{3

4}; Australian Ovarian Cancer Study Group; Harvey A Risch⁵, Mary Anne Rossing^{1

2}, Jennifer A Doherty⁶, Marc T Goodman^{7

8}, Francesmary Modugno⁹, Roberta B Ness¹⁰, Kirsten B Moysich¹¹, Susanne K Kjær^{12

13}, Estrid Høgdall^{12

14}, Allan Jensen¹², Joellen M Schildkraut¹⁵, Andrew Berchuck¹⁶, Daniel W Cramer^{17

18}, Elisa V Bandera¹⁹, Lorna Rodriguez¹⁹, Nicolas Wentzensen²⁰, Joanne Kotsopoulos²¹, Steven A Narod²¹, John R McLaughlin²², Hoda Anton-Culver²³, Argyrios Ziogas²³, Celeste L Pearce^{24

25}, Anna H Wu²⁵, Sara Lindström^{1

2}, Kathryn L Terry^{17

18}

Affiliations

¹ Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
² Department of Epidemiology, University of Washington, Seattle, WA, USA.
³ Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
⁴ School of Public Health, University of Queensland, Herston, Queensland, Australia.
⁵ Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
⁶ Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
⁷ Caner Prevention and Genetics Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁸ Department of Biomedical Sciences, Community and Population Health Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁹ Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
¹⁰ The University of Texas School of Public Health, Houston, TX, USA.
¹¹ Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA.
¹² Department of Virus, Lifestyle and Genes, Danish Cancer Society Research Center, Copenhagen, Denmark.
¹³ Department of Gynaecology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
¹⁴ Molecular Unit, Department of Pathology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.
¹⁵ Department of Public Health Sciences, The University of Virginia, Charlottesville, VA, USA.
¹⁶ Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, USA.
¹⁷ Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
¹⁸ Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
¹⁹ Division of Obstetrics and Gynecology, The Cancer Institute of New Jersey, Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
²⁰ Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
²¹ Epidemiology Division, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada.
²² Public Health Ontario, Samuel Lunenfeld Research Institute, Toronto, Canada.
²³ Department of Medicine, University of California Irvine, Irvine, CA, USA.
²⁴ Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA.
²⁵ Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA, USA.

Abstract

Background: Polycystic ovary syndrome (PCOS) is a complex endocrine disorder with an estimated prevalence of 4-21% in reproductive aged women. Recently, the Ovarian Cancer Association Consortium (OCAC) reported a decreased risk of invasive ovarian cancer among women with self-reported PCOS. However, given the limitations of self-reported PCOS, the validity of these observed associations remains uncertain. Therefore, we sought to use Mendelian randomization with genetic markers as a proxy for PCOS, to examine the association between PCOS and ovarian cancer.

Methods: Utilizing 14 single nucleotide polymorphisms (SNPs) previously associated with PCOS we assessed the association between genetically predicted PCOS and ovarian cancer risk, overall and by histotype, using summary statistics from a previously conducted genome-wide association study (GWAS) of ovarian cancer among European ancestry women within the OCAC (22 406 with invasive disease, 3103 with borderline disease and 40 941 controls).

Results: An inverse association was observed between genetically predicted PCOS and invasive ovarian cancer risk: odds ratio (OR)=0.92 [95% confidence interval (CI)=0.85-0.99; P = 0.03]. When results were examined by histotype, the strongest inverse association was observed between genetically predicted PCOS and endometrioid tumors (OR = 0.77; 95% CI = 0.65-0.92; P = 0.003). Adjustment for individual-level body mass index, oral contraceptive use and parity did not materially change the associations.

Conclusion: Our study provides evidence for a relationship between PCOS and reduced ovarian cancer risk, overall and among specific histotypes of invasive ovarian cancer. These results lend support to our previous observational study results. Future studies are needed to understand mechanisms underlying this association.

Keywords: Mendelian randomization; Polycystic ovary syndrome; histotype; ovarian cancer.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adenocarcinoma, Clear Cell / epidemiology*
Adenocarcinoma, Mucinous / epidemiology*
Carcinoma, Endometrioid / epidemiology*
Female
Humans
Mendelian Randomization Analysis
Neoplasms, Cystic, Mucinous, and Serous / epidemiology
Ovarian Neoplasms / epidemiology*
Polycystic Ovary Syndrome / epidemiology*
Polycystic Ovary Syndrome / genetics

Abstract

Publication types

MeSH terms

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