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Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women
Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy‐related factors on risk is not well understood. This population‐based case–control study included all parous...
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| Published in: | International journal of cancer 2018-10, Vol.143 (8), p.1858-1867 |
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| cites | cdi_FETCH-LOGICAL-c5181-48878a89da3eea965767cb021d04f92acd51f3cc87501c877fc1b14f001e2ec13 |
| container_end_page | 1867 |
| container_issue | 8 |
| container_start_page | 1858 |
| container_title | International journal of cancer |
| container_volume | 143 |
| creator | Sköld, Camilla Bjørge, Tone Ekbom, Anders Engeland, Anders Gissler, Mika Grotmol, Tom Madanat‐Harjuoja, Laura Gulbech Ording, Anne Stephansson, Olof Trabert, Britton Tretli, Steinar Troisi, Rebecca Toft Sørensen, Henrik Glimelius, Ingrid |
| description | Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy‐related factors on risk is not well understood. This population‐based case–control study included all parous women with epithelial ovarian cancer in Denmark, Finland, Norway and Sweden during 1967–2013 (n = 10,957) and up to 10 matched controls (n = 107,864). We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for pregnancy‐related factors and ovarian cancer risk by histological subtype. Preterm delivery was associated with an increased risk [pregnancy length (last pregnancy) ≤30 vs. 39–41 weeks, OR 1.33 (95% CI 1.06–1.67), adjusted for number of births]; the OR increased as pregnancy length decreased (p for trend |
| doi_str_mv | 10.1002/ijc.31581 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_swepu</sourceid><recordid>TN_cdi_swepub_primary_oai_swepub_ki_se_488571</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2100364194</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5181-48878a89da3eea965767cb021d04f92acd51f3cc87501c877fc1b14f001e2ec13</originalsourceid><addsrcrecordid>eNp1kk1v1DAQhi0EokvhwB9AlriARFqPE8fJBalavooqwQG4Wl5nsvU2ibf2Zlf775klS0WRerGtmcevZ8YvYy9BnIEQ8tyv3FkOqoJHbAai1pmQoB6zGeVEpiEvT9izlFZCAChRPGUnsta5VrKaMfwecYOx5w12fotxz33iNqXgvN1gw3d-c83twP3gItpEkejTDQ8txzWl6JLteNja6AlydnAYue3DsORrG8OY-C70ODxnT1rbJXxx3E_Zz08ff8y_ZFffPl_OL64yp6CCrKgqXdmqbmyOaOtS6VK7BTXTiKKtpXWNgjZ3rtJKAK26dbCAoqXGUKKD_JRlk27a4XpcmHX0vY17E6w3x9ANndDQS0of-HcP8h_8rwsT4tKMo8nLAmRJ-PsJJ7bHxuGwiba7d-t-ZvDXZhm2pgRZ6aIggTdHgRhuR0wb0_vksOvsgDQsI0VeSgG1VoS-_g9dhTEOND0j6dMPFdUHwbcT5WJIKWJ7VwwIc_CGIW-YP94g9tW_1d-Rf81AwPkE7HyH-4eVzOXX-ST5G0xPxRM</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2100364194</pqid></control><display><type>article</type><title>Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women</title><source>Wiley</source><creator>Sköld, Camilla ; Bjørge, Tone ; Ekbom, Anders ; Engeland, Anders ; Gissler, Mika ; Grotmol, Tom ; Madanat‐Harjuoja, Laura ; Gulbech Ording, Anne ; Stephansson, Olof ; Trabert, Britton ; Tretli, Steinar ; Troisi, Rebecca ; Toft Sørensen, Henrik ; Glimelius, Ingrid</creator><creatorcontrib>Sköld, Camilla ; Bjørge, Tone ; Ekbom, Anders ; Engeland, Anders ; Gissler, Mika ; Grotmol, Tom ; Madanat‐Harjuoja, Laura ; Gulbech Ording, Anne ; Stephansson, Olof ; Trabert, Britton ; Tretli, Steinar ; Troisi, Rebecca ; Toft Sørensen, Henrik ; Glimelius, Ingrid</creatorcontrib><description>Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy‐related factors on risk is not well understood. This population‐based case–control study included all parous women with epithelial ovarian cancer in Denmark, Finland, Norway and Sweden during 1967–2013 (n = 10,957) and up to 10 matched controls (n = 107,864). We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for pregnancy‐related factors and ovarian cancer risk by histological subtype. Preterm delivery was associated with an increased risk [pregnancy length (last pregnancy) ≤30 vs. 39–41 weeks, OR 1.33 (95% CI 1.06–1.67), adjusted for number of births]; the OR increased as pregnancy length decreased (p for trend < 0.001). Older age at first and last birth was associated with a decreased risk [first birth: 30–39 vs. <25 years: adjusted OR 0.76 (95% CI 0.70–0.83); last birth 30–39 vs. <25 years: adjusted OR 0.76 (95% CI 0.71–0.82)]. Increasing number of births was protective [≥4 births vs. 1; OR 0.63 (95% CI 0.59–0.68)] for all subtypes, most pronounced for clear‐cell tumors [OR 0.30, (95% CI 0.21–0.44), pheterogeneity < 0.001]. No associations were observed for multiple pregnancies, preeclampsia or offspring size. In conclusion, in addition to high parity, full‐term pregnancies and pregnancies at older ages were associated with decreased risk of ovarian cancer. Our findings favor the cell clearance hypothesis, i.e. a recent pregnancy provides protection by clearing of precancerous cells from the epithelium of the ovary/fallopian tubes, mediated by placental or ovarian hormones.
What's new?
The more children a woman gives birth to, the lower her risk of epithelial ovarian cancer. Whether specific factors such as pregnancy length or maternal age impact this risk, however, is unclear. This large case‐control study shows that among parous women, preterm birth is associated with increased risk of epithelial ovarian cancer. Increasing number of births and pregnancies at older maternal age was associated with decreased risk of the disease. The findings lend support to the idea that a recent full‐term pregnancy clears precancerous cells from the epithelium of the ovaries and fallopian tubes, thereby defending against ovarian malignancy.</description><identifier>ISSN: 0020-7136</identifier><identifier>ISSN: 1097-0215</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.31581</identifier><identifier>PMID: 29737528</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Age Factors ; Aged ; Birth ; Births ; Cancer ; Carcinoma, Ovarian Epithelial - etiology ; Case-Control Studies ; Denmark ; Epithelium ; Etiology ; Female ; Finland ; Health risk assessment ; Health risks ; Humans ; Logistic Models ; Medical research ; Middle Aged ; Norway ; Odds Ratio ; Offspring ; Ovarian cancer ; Ovarian Neoplasms - etiology ; Parity ; Parity - physiology ; Parturition ; Placenta ; Placenta - physiopathology ; Population studies ; Pre-eclampsia ; Preeclampsia ; Pregnancy ; Premature Birth - physiopathology ; Risk Factors ; Sweden ; Tumors ; Womens health</subject><ispartof>International journal of cancer, 2018-10, Vol.143 (8), p.1858-1867</ispartof><rights>2018 UICC</rights><rights>2018 UICC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5181-48878a89da3eea965767cb021d04f92acd51f3cc87501c877fc1b14f001e2ec13</citedby><cites>FETCH-LOGICAL-c5181-48878a89da3eea965767cb021d04f92acd51f3cc87501c877fc1b14f001e2ec13</cites><orcidid>0000-0001-8212-0003</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29737528$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-364126$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:139115902$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Sköld, Camilla</creatorcontrib><creatorcontrib>Bjørge, Tone</creatorcontrib><creatorcontrib>Ekbom, Anders</creatorcontrib><creatorcontrib>Engeland, Anders</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Grotmol, Tom</creatorcontrib><creatorcontrib>Madanat‐Harjuoja, Laura</creatorcontrib><creatorcontrib>Gulbech Ording, Anne</creatorcontrib><creatorcontrib>Stephansson, Olof</creatorcontrib><creatorcontrib>Trabert, Britton</creatorcontrib><creatorcontrib>Tretli, Steinar</creatorcontrib><creatorcontrib>Troisi, Rebecca</creatorcontrib><creatorcontrib>Toft Sørensen, Henrik</creatorcontrib><creatorcontrib>Glimelius, Ingrid</creatorcontrib><title>Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy‐related factors on risk is not well understood. This population‐based case–control study included all parous women with epithelial ovarian cancer in Denmark, Finland, Norway and Sweden during 1967–2013 (n = 10,957) and up to 10 matched controls (n = 107,864). We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for pregnancy‐related factors and ovarian cancer risk by histological subtype. Preterm delivery was associated with an increased risk [pregnancy length (last pregnancy) ≤30 vs. 39–41 weeks, OR 1.33 (95% CI 1.06–1.67), adjusted for number of births]; the OR increased as pregnancy length decreased (p for trend < 0.001). Older age at first and last birth was associated with a decreased risk [first birth: 30–39 vs. <25 years: adjusted OR 0.76 (95% CI 0.70–0.83); last birth 30–39 vs. <25 years: adjusted OR 0.76 (95% CI 0.71–0.82)]. Increasing number of births was protective [≥4 births vs. 1; OR 0.63 (95% CI 0.59–0.68)] for all subtypes, most pronounced for clear‐cell tumors [OR 0.30, (95% CI 0.21–0.44), pheterogeneity < 0.001]. No associations were observed for multiple pregnancies, preeclampsia or offspring size. In conclusion, in addition to high parity, full‐term pregnancies and pregnancies at older ages were associated with decreased risk of ovarian cancer. Our findings favor the cell clearance hypothesis, i.e. a recent pregnancy provides protection by clearing of precancerous cells from the epithelium of the ovary/fallopian tubes, mediated by placental or ovarian hormones.
What's new?
The more children a woman gives birth to, the lower her risk of epithelial ovarian cancer. Whether specific factors such as pregnancy length or maternal age impact this risk, however, is unclear. This large case‐control study shows that among parous women, preterm birth is associated with increased risk of epithelial ovarian cancer. Increasing number of births and pregnancies at older maternal age was associated with decreased risk of the disease. The findings lend support to the idea that a recent full‐term pregnancy clears precancerous cells from the epithelium of the ovaries and fallopian tubes, thereby defending against ovarian malignancy.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Birth</subject><subject>Births</subject><subject>Cancer</subject><subject>Carcinoma, Ovarian Epithelial - etiology</subject><subject>Case-Control Studies</subject><subject>Denmark</subject><subject>Epithelium</subject><subject>Etiology</subject><subject>Female</subject><subject>Finland</subject><subject>Health risk assessment</subject><subject>Health risks</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Medical research</subject><subject>Middle Aged</subject><subject>Norway</subject><subject>Odds Ratio</subject><subject>Offspring</subject><subject>Ovarian cancer</subject><subject>Ovarian Neoplasms - etiology</subject><subject>Parity</subject><subject>Parity - physiology</subject><subject>Parturition</subject><subject>Placenta</subject><subject>Placenta - physiopathology</subject><subject>Population studies</subject><subject>Pre-eclampsia</subject><subject>Preeclampsia</subject><subject>Pregnancy</subject><subject>Premature Birth - physiopathology</subject><subject>Risk Factors</subject><subject>Sweden</subject><subject>Tumors</subject><subject>Womens health</subject><issn>0020-7136</issn><issn>1097-0215</issn><issn>1097-0215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp1kk1v1DAQhi0EokvhwB9AlriARFqPE8fJBalavooqwQG4Wl5nsvU2ibf2Zlf775klS0WRerGtmcevZ8YvYy9BnIEQ8tyv3FkOqoJHbAai1pmQoB6zGeVEpiEvT9izlFZCAChRPGUnsta5VrKaMfwecYOx5w12fotxz33iNqXgvN1gw3d-c83twP3gItpEkejTDQ8txzWl6JLteNja6AlydnAYue3DsORrG8OY-C70ODxnT1rbJXxx3E_Zz08ff8y_ZFffPl_OL64yp6CCrKgqXdmqbmyOaOtS6VK7BTXTiKKtpXWNgjZ3rtJKAK26dbCAoqXGUKKD_JRlk27a4XpcmHX0vY17E6w3x9ANndDQS0of-HcP8h_8rwsT4tKMo8nLAmRJ-PsJJ7bHxuGwiba7d-t-ZvDXZhm2pgRZ6aIggTdHgRhuR0wb0_vksOvsgDQsI0VeSgG1VoS-_g9dhTEOND0j6dMPFdUHwbcT5WJIKWJ7VwwIc_CGIW-YP94g9tW_1d-Rf81AwPkE7HyH-4eVzOXX-ST5G0xPxRM</recordid><startdate>20181015</startdate><enddate>20181015</enddate><creator>Sköld, Camilla</creator><creator>Bjørge, Tone</creator><creator>Ekbom, Anders</creator><creator>Engeland, Anders</creator><creator>Gissler, Mika</creator><creator>Grotmol, Tom</creator><creator>Madanat‐Harjuoja, Laura</creator><creator>Gulbech Ording, Anne</creator><creator>Stephansson, Olof</creator><creator>Trabert, Britton</creator><creator>Tretli, Steinar</creator><creator>Troisi, Rebecca</creator><creator>Toft Sørensen, Henrik</creator><creator>Glimelius, Ingrid</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>DF2</scope><scope>D8T</scope><scope>ZZAVC</scope><orcidid>https://orcid.org/0000-0001-8212-0003</orcidid></search><sort><creationdate>20181015</creationdate><title>Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women</title><author>Sköld, Camilla ; Bjørge, Tone ; Ekbom, Anders ; Engeland, Anders ; Gissler, Mika ; Grotmol, Tom ; Madanat‐Harjuoja, Laura ; Gulbech Ording, Anne ; Stephansson, Olof ; Trabert, Britton ; Tretli, Steinar ; Troisi, Rebecca ; Toft Sørensen, Henrik ; Glimelius, Ingrid</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5181-48878a89da3eea965767cb021d04f92acd51f3cc87501c877fc1b14f001e2ec13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Birth</topic><topic>Births</topic><topic>Cancer</topic><topic>Carcinoma, Ovarian Epithelial - etiology</topic><topic>Case-Control Studies</topic><topic>Denmark</topic><topic>Epithelium</topic><topic>Etiology</topic><topic>Female</topic><topic>Finland</topic><topic>Health risk assessment</topic><topic>Health risks</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Medical research</topic><topic>Middle Aged</topic><topic>Norway</topic><topic>Odds Ratio</topic><topic>Offspring</topic><topic>Ovarian cancer</topic><topic>Ovarian Neoplasms - etiology</topic><topic>Parity</topic><topic>Parity - physiology</topic><topic>Parturition</topic><topic>Placenta</topic><topic>Placenta - physiopathology</topic><topic>Population studies</topic><topic>Pre-eclampsia</topic><topic>Preeclampsia</topic><topic>Pregnancy</topic><topic>Premature Birth - physiopathology</topic><topic>Risk Factors</topic><topic>Sweden</topic><topic>Tumors</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Sköld, Camilla</creatorcontrib><creatorcontrib>Bjørge, Tone</creatorcontrib><creatorcontrib>Ekbom, Anders</creatorcontrib><creatorcontrib>Engeland, Anders</creatorcontrib><creatorcontrib>Gissler, Mika</creatorcontrib><creatorcontrib>Grotmol, Tom</creatorcontrib><creatorcontrib>Madanat‐Harjuoja, Laura</creatorcontrib><creatorcontrib>Gulbech Ording, Anne</creatorcontrib><creatorcontrib>Stephansson, Olof</creatorcontrib><creatorcontrib>Trabert, Britton</creatorcontrib><creatorcontrib>Tretli, Steinar</creatorcontrib><creatorcontrib>Troisi, Rebecca</creatorcontrib><creatorcontrib>Toft Sørensen, Henrik</creatorcontrib><creatorcontrib>Glimelius, Ingrid</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Uppsala universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>International journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sköld, Camilla</au><au>Bjørge, Tone</au><au>Ekbom, Anders</au><au>Engeland, Anders</au><au>Gissler, Mika</au><au>Grotmol, Tom</au><au>Madanat‐Harjuoja, Laura</au><au>Gulbech Ording, Anne</au><au>Stephansson, Olof</au><au>Trabert, Britton</au><au>Tretli, Steinar</au><au>Troisi, Rebecca</au><au>Toft Sørensen, Henrik</au><au>Glimelius, Ingrid</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2018-10-15</date><risdate>2018</risdate><volume>143</volume><issue>8</issue><spage>1858</spage><epage>1867</epage><pages>1858-1867</pages><issn>0020-7136</issn><issn>1097-0215</issn><eissn>1097-0215</eissn><abstract>Epithelial ovarian cancer is a fatal disease of largely unknown etiology. Higher parity is associated with reduced risk of ovarian cancer. However, among parous women, the impact of pregnancy‐related factors on risk is not well understood. This population‐based case–control study included all parous women with epithelial ovarian cancer in Denmark, Finland, Norway and Sweden during 1967–2013 (n = 10,957) and up to 10 matched controls (n = 107,864). We used conditional logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (CIs) for pregnancy‐related factors and ovarian cancer risk by histological subtype. Preterm delivery was associated with an increased risk [pregnancy length (last pregnancy) ≤30 vs. 39–41 weeks, OR 1.33 (95% CI 1.06–1.67), adjusted for number of births]; the OR increased as pregnancy length decreased (p for trend < 0.001). Older age at first and last birth was associated with a decreased risk [first birth: 30–39 vs. <25 years: adjusted OR 0.76 (95% CI 0.70–0.83); last birth 30–39 vs. <25 years: adjusted OR 0.76 (95% CI 0.71–0.82)]. Increasing number of births was protective [≥4 births vs. 1; OR 0.63 (95% CI 0.59–0.68)] for all subtypes, most pronounced for clear‐cell tumors [OR 0.30, (95% CI 0.21–0.44), pheterogeneity < 0.001]. No associations were observed for multiple pregnancies, preeclampsia or offspring size. In conclusion, in addition to high parity, full‐term pregnancies and pregnancies at older ages were associated with decreased risk of ovarian cancer. Our findings favor the cell clearance hypothesis, i.e. a recent pregnancy provides protection by clearing of precancerous cells from the epithelium of the ovary/fallopian tubes, mediated by placental or ovarian hormones.
What's new?
The more children a woman gives birth to, the lower her risk of epithelial ovarian cancer. Whether specific factors such as pregnancy length or maternal age impact this risk, however, is unclear. This large case‐control study shows that among parous women, preterm birth is associated with increased risk of epithelial ovarian cancer. Increasing number of births and pregnancies at older maternal age was associated with decreased risk of the disease. The findings lend support to the idea that a recent full‐term pregnancy clears precancerous cells from the epithelium of the ovaries and fallopian tubes, thereby defending against ovarian malignancy.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29737528</pmid><doi>10.1002/ijc.31581</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0001-8212-0003</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of cancer, 2018-10, Vol.143 (8), p.1858-1867 |
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| subjects | Adult Age Factors Aged Birth Births Cancer Carcinoma, Ovarian Epithelial - etiology Case-Control Studies Denmark Epithelium Etiology Female Finland Health risk assessment Health risks Humans Logistic Models Medical research Middle Aged Norway Odds Ratio Offspring Ovarian cancer Ovarian Neoplasms - etiology Parity Parity - physiology Parturition Placenta Placenta - physiopathology Population studies Pre-eclampsia Preeclampsia Pregnancy Premature Birth - physiopathology Risk Factors Sweden Tumors Womens health |
| title | Preterm delivery is associated with an increased risk of epithelial ovarian cancer among parous women |
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