Background Women with a family history of breast and/or ovarian cancer have an increased ovarian cancer risk. Yet it remains uncertain if common ovarian cancer risk factors—especially those which are modifiable—affect this high-risk population similarly to the general population. Methods Using the Danish and Swedish nationwide registers, we established two nested case-control study populations in women with a family history of breast and/or ovarian cancer (2,138 ovarian cancers, 85,240 controls) and women without (10,730 ovarian cancers, 429,200 controls). The overall and histology-specific associations were assessed with conditional logistic regression. The country-specific estimates were combined based on a fixed-effect assumption. Results Multiparity, hysterectomy, tubal ligation, salpingectomy, and oral contraceptive (OC) use were associated with a reduced risk of ovarian cancer in both women with and without a family history, while endometriosis and menopausal hormone treatment (MHT) were associated with increased risk. Multiparity and OC use presented protective effects across all histologic subtypes except mucinous ovarian cancer which was not associated with OC use. MHT increased the risk of serous ovarian cancer but decreased the risk of the mucinous and clear cell cancers. Endometriosis was especially related to an increased risk of endometrioid and clear cell ovarian cancer. Conclusion Factors associated with a decreased ovarian cancer risk were similar between women with and without a family history of breast and/or ovarian cancer. Given the higher baseline risk for women with a family history, special attention should be paid to risk factors like endometriosis and nulliparity in this high-risk population.

中文翻译：

---

与家族史相关的卵巢癌危险因素


背景 有乳腺癌和/或卵巢癌家族史的女性患卵巢癌的风险增加。然而，目前尚不确定常见的卵巢癌危险因素（尤其是那些可改变的因素）是否会像一般人群一样影响这一高危人群。方法 利用丹麦和瑞典全国登记册，我们建立了两个巢式病例对照研究人群，其中包括有乳腺癌和/或卵巢癌家族史的女性（2,138 名卵巢癌患者，85,240 名对照者）和没有乳腺癌和/或卵巢癌家族史的女性（10,730 名卵巢癌患者，429,200 名对照者） 。用条件逻辑回归评估总体和组织学特异性关联。特定国家的估计是根据固定效应假设合并的。结果 无论有或无家族史，多产、子宫切除术、输卵管结扎、输卵管切除术和口服避孕药 (OC) 的使用均与卵巢癌风险降低相关，而子宫内膜异位症和绝经激素治疗 (MHT) 则与风险增加相关。多产和 OC 使用对所有组织学亚型均具有保护作用，但与 OC 使用无关的粘液性卵巢癌除外。 MHT 增加了浆液性卵巢癌的风险，但降低了粘液性和透明细胞癌的风险。子宫内膜异位症与子宫内膜样癌和透明细胞卵巢癌的风险增加尤其相关。结论 在有和没有乳腺癌和/或卵巢癌家族史的女性中，与卵巢癌风险降低相关的因素相似。鉴于有家族史的女性基线风险较高，应特别关注这一高危人群的子宫内膜异位症和未生育等风险因素。