Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study
Identifieur interne : 000708 ( Pmc/Curation ); précédent : 000707; suivant : 000709Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study
Auteurs : Jelena Beševi [Royaume-Uni] ; Marc J. Gunter [Royaume-Uni] ; Renée T. Fortner [Allemagne] ; Konstantinos K. Tsilidis [Royaume-Uni, Grèce] ; Elisabete Weiderpass [Norvège, Suède, Finlande] ; N. Charlotte Onland-Moret [Pays-Bas] ; Laure Dossus [France] ; Anne Tj Nneland [Danemark] ; Louise Hansen [Danemark] ; Kim Overvad [Danemark] ; Sylvie Mesrine [France] ; Laura Baglietto [Australie] ; Françoise Clavel-Chapelon [France] ; Rudolf Kaaks [Allemagne] ; Krasimira Aleksandrova [Allemagne] ; Heiner Boeing [Allemagne] ; Antonia Trichopoulou [Grèce] ; Pagona Lagiou [États-Unis, Grèce] ; Christina Bamia [Grèce] ; Giovanna Masala [Italie] ; Claudia Agnoli [Italie] ; Rosario Tumino [Italie] ; Fulvio Ricceri [Italie] ; Salvatore Panico [Italie] ; Hb As Bueno-De-Mesquita [Royaume-Uni, Pays-Bas, Malaisie] ; Petra H. Peeters [Royaume-Uni, Pays-Bas] ; Mie Jareid [Norvège] ; J. Ram N Quir S [Espagne] ; Eric J. Duell [Espagne] ; María-José Sánchez [Espagne] ; Nerea Larra Aga [Espagne] ; María-Dolores Chirlaque [Espagne] ; Aurelio Barricarte [Espagne] ; Joana A. Dias [Suède] ; Emily Sonestedt [Suède] ; Annika Idahl [Suède] ; Eva Lundin [Suède] ; Nicholas J. Wareham [Royaume-Uni] ; Kay-Tee Khaw [Royaume-Uni] ; Ruth C. Travis [Royaume-Uni] ; Sabina Rinaldi [France] ; Isabelle Romieu [France] ; Elio Riboli [Royaume-Uni] ; Melissa A. Merritt [Royaume-Uni]Source :
- British Journal of Cancer [ 0007-0920 ] ; 2015.
Abstract
Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25–70 years at recruitment from 1992 to 2000.
Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.
After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever
Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.
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DOI: 10.1038/bjc.2015.377
PubMed: 26554655
PubMed Central: 4705888
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id="aff10"><institution>Université Paris Sud, UMRS 1018</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff11"><institution>Institut Gustave Roussy</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tj Nneland, Anne" sort="Tj Nneland, Anne" uniqKey="Tj Nneland A" first="Anne" last="Tj Nneland">Anne Tj Nneland</name><affiliation wicri:level="1"><nlm:aff id="aff12"><institution>Danish Cancer Society Research Center</institution>, Strandboulevarden 49, Copenhagen DK-2100,<country>Denmark</country></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name 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strict</wicri:regionArea></affiliation></author><author><name sortKey="Baglietto, Laura" sort="Baglietto, Laura" uniqKey="Baglietto L" first="Laura" last="Baglietto">Laura Baglietto</name><affiliation wicri:level="1"><nlm:aff id="aff14"><institution>Cancer Epidemiology Center, Cancer Council of Victoria</institution>, 615 St Kilda Road, Melbourne 3004, Victoria,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff15"><institution>Center for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne</institution>, Melbourne 3010, Victoria,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Clavel Chapelon, Francoise" sort="Clavel Chapelon, Francoise" uniqKey="Clavel 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strict</wicri:regionArea></affiliation></author><author><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)</institution>, Im Neuenheimer Feld 280, Heidelberg 69120,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Aleksandrova, Krasimira" sort="Aleksandrova, Krasimira" uniqKey="Aleksandrova K" first="Krasimira" last="Aleksandrova">Krasimira Aleksandrova</name><affiliation wicri:level="1"><nlm:aff id="aff16"><institution>Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke</institution>, Arthur-Scheunert-Allee 114–116, Nuthetal 14558,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Boeing, Heiner" sort="Boeing, Heiner" uniqKey="Boeing H" first="Heiner" last="Boeing">Heiner Boeing</name><affiliation wicri:level="1"><nlm:aff id="aff16"><institution>Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke</institution>, Arthur-Scheunert-Allee 114–116, Nuthetal 14558,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Trichopoulou, Antonia" sort="Trichopoulou, Antonia" uniqKey="Trichopoulou A" first="Antonia" last="Trichopoulou">Antonia Trichopoulou</name><affiliation wicri:level="1"><nlm:aff id="aff17"><institution>Hellenic Health Foundation</institution>, 13 Kaisareias Street, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff18"><institution>Bureau of Epidemiologic Research, Academy of Athens</institution>, 23 Alexandroupoleos Street, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lagiou, Pagona" sort="Lagiou, Pagona" uniqKey="Lagiou P" first="Pagona" last="Lagiou">Pagona Lagiou</name><affiliation wicri:level="1"><nlm:aff id="aff19"> Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff20"><institution>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School</institution>, Mikras Asias 75, Goudi, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bamia, Christina" sort="Bamia, Christina" uniqKey="Bamia C" first="Christina" last="Bamia">Christina Bamia</name><affiliation wicri:level="1"><nlm:aff id="aff20"><institution>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School</institution>, Mikras Asias 75, Goudi, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Masala, Giovanna" sort="Masala, Giovanna" uniqKey="Masala G" first="Giovanna" last="Masala">Giovanna Masala</name><affiliation wicri:level="1"><nlm:aff id="aff21"><institution>Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO</institution>, Ponte Nuovo Palazzina 28A ‘Mario Fiori', Via delle Oblate 4, Florence 50141,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Agnoli, Claudia" sort="Agnoli, Claudia" uniqKey="Agnoli C" first="Claudia" last="Agnoli">Claudia Agnoli</name><affiliation wicri:level="1"><nlm:aff id="aff22"><institution>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori</institution>, Via Venezian, 1, Milano 20133,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tumino, Rosario" sort="Tumino, Rosario" uniqKey="Tumino R" first="Rosario" last="Tumino">Rosario Tumino</name><affiliation wicri:level="1"><nlm:aff id="aff23"><institution>Cancer Registry and Histopathology Unit, ‘Civic–M.P. Arezzo' Hospital, ASP</institution>, Via Dante No. 109, Ragusa 97100,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ricceri, Fulvio" sort="Ricceri, Fulvio" uniqKey="Ricceri F" first="Fulvio" last="Ricceri">Fulvio Ricceri</name><affiliation wicri:level="1"><nlm:aff id="aff24"><institution>Unit of Epidemiology, Regional Health Service ASL TO3</institution>, Via Sabaudia 164, Grugliasco (TO) 10095,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff25"><institution>Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin</institution>, Via Santena 7, Turin 10126,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Panico, Salvatore" sort="Panico, Salvatore" uniqKey="Panico S" first="Salvatore" last="Panico">Salvatore Panico</name><affiliation wicri:level="1"><nlm:aff id="aff26"><institution>Dipartimento di Medicina Clinica e Chirurgia, Federico II University</institution>, via Pansini 5, 80131 Naples,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bueno De Mesquita, Hb As" sort="Bueno De Mesquita, Hb As" uniqKey="Bueno De Mesquita H" first="Hb As" last="Bueno-De-Mesquita">Hb As Bueno-De-Mesquita</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff27"><institution>Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM)</institution>, PO Box 1, Bilthoven 3720 BA,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff28"><institution>Department of Gastroenterology and Hepatology, University Medical Center Utrecht</institution>, Heidelberglann 100, Utrecht 3584 cx,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff29"><institution>Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya</institution>, Kuala Lumpur 50603,<country>Malaysia</country></nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Peeters, Petra H" sort="Peeters, Petra H" uniqKey="Peeters P" first="Petra H" last="Peeters">Petra H. Peeters</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht</institution>, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jareid, Mie" sort="Jareid, Mie" uniqKey="Jareid M" first="Mie" last="Jareid">Mie Jareid</name><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway</institution>, Tromsø N–9037,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ram N Quir S, J" sort="Ram N Quir S, J" uniqKey="Ram N Quir S J" first="J" last="Ram N Quir S">J. Ram N Quir S</name><affiliation wicri:level="1"><nlm:aff id="aff30"><institution>Public Health Directorate, Asturias</institution>, Ciriaco Miguel Vigil St 9, Oviedo 33006,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Duell, Eric J" sort="Duell, Eric J" uniqKey="Duell E" first="Eric J" last="Duell">Eric J. Duell</name><affiliation wicri:level="1"><nlm:aff id="aff31"><institution>Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL)</institution>, Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sanchez, Maria Jose" sort="Sanchez, Maria Jose" uniqKey="Sanchez M" first="María-José" last="Sánchez">María-José Sánchez</name><affiliation wicri:level="1"><nlm:aff id="aff32"><institution>Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio</institution>, 4, Campus Universitario de Cartuja, Granada 18080,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Larra Aga, Nerea" sort="Larra Aga, Nerea" uniqKey="Larra Aga N" first="Nerea" last="Larra Aga">Nerea Larra Aga</name><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff34"><institution>Public Health Division of Gipuzkoa, Regional Government of the Basque Country</institution>, Donostia,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chirlaque, Maria Dolores" sort="Chirlaque, Maria Dolores" uniqKey="Chirlaque M" first="María-Dolores" last="Chirlaque">María-Dolores Chirlaque</name><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff35"><institution>Department of Epidemiology, Murcia Regional Health Council, IMIB–Arrixaca</institution>, Ronda de Levante 11, Murcia 30008,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Barricarte, Aurelio" sort="Barricarte, Aurelio" uniqKey="Barricarte A" first="Aurelio" last="Barricarte">Aurelio Barricarte</name><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff36"><institution>Navarra Public Health Institute</institution>, c/Leyre 15, Pamplona 31003,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff37"><institution>IdiSNA, Navarra Institute for Health Research</institution>, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona 31008,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dias, Joana A" sort="Dias, Joana A" uniqKey="Dias J" first="Joana A" last="Dias">Joana A. Dias</name><affiliation wicri:level="1"><nlm:aff id="aff38"><institution>Department of Clinical Sciences Malmö, Lund University</institution>, Malmö 20502,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sonestedt, Emily" sort="Sonestedt, Emily" uniqKey="Sonestedt E" first="Emily" last="Sonestedt">Emily Sonestedt</name><affiliation wicri:level="1"><nlm:aff id="aff38"><institution>Department of Clinical Sciences Malmö, Lund University</institution>, Malmö 20502,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Idahl, Annika" sort="Idahl, Annika" uniqKey="Idahl A" first="Annika" last="Idahl">Annika Idahl</name><affiliation wicri:level="1"><nlm:aff id="aff39"><institution>Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University</institution>, SE-901 87 Umeå,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff40"><institution>Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University</institution>, SE-901 87 Umeå,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lundin, Eva" sort="Lundin, Eva" uniqKey="Lundin E" first="Eva" last="Lundin">Eva Lundin</name><affiliation wicri:level="1"><nlm:aff id="aff41"><institution>Department of Medical Biosciences and Pathology, Umeå University</institution>, Umeå SE-901 87,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wareham, Nicholas J" sort="Wareham, Nicholas J" uniqKey="Wareham N" first="Nicholas J" last="Wareham">Nicholas J. Wareham</name><affiliation wicri:level="1"><nlm:aff id="aff42"><institution>MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital</institution>, Hills Road, Cambridge CB2 0QQ,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Khaw, Kay Tee" sort="Khaw, Kay Tee" uniqKey="Khaw K" first="Kay-Tee" last="Khaw">Kay-Tee Khaw</name><affiliation wicri:level="1"><nlm:aff id="aff43"><institution>School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital</institution>, Hills Rd, Cambridge CB2 0SP,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Travis, Ruth C" sort="Travis, Ruth C" uniqKey="Travis R" first="Ruth C" last="Travis">Ruth C. Travis</name><affiliation wicri:level="1"><nlm:aff id="aff44"><institution>Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford</institution>, Richard Doll Building, Oxford OX3 7LF,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Rinaldi, Sabina" sort="Rinaldi, Sabina" uniqKey="Rinaldi S" first="Sabina" last="Rinaldi">Sabina Rinaldi</name><affiliation wicri:level="1"><nlm:aff id="aff45"><institution>International Agency for Research on Cancer</institution>, 150 Cours Albert-Thomas, Lyon Cedex 08 69372,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Romieu, Isabelle" sort="Romieu, Isabelle" uniqKey="Romieu I" first="Isabelle" last="Romieu">Isabelle Romieu</name><affiliation wicri:level="1"><nlm:aff id="aff45"><institution>International Agency for Research on Cancer</institution>, 150 Cours Albert-Thomas, Lyon Cedex 08 69372,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Merritt, Melissa A" sort="Merritt, Melissa A" uniqKey="Merritt M" first="Melissa A" last="Merritt">Melissa A. Merritt</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26554655</idno><idno type="pmc">4705888</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705888</idno><idno type="RBID">PMC:4705888</idno><idno type="doi">10.1038/bjc.2015.377</idno><date when="2015">2015</date><idno type="wicri:Area/Pmc/Corpus">000709</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000709</idno><idno type="wicri:Area/Pmc/Curation">000708</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000708</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study</title><author><name sortKey="Besevi, Jelena" sort="Besevi, Jelena" uniqKey="Besevi J" first="Jelena" last="Beševi">Jelena Beševi</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Gunter, Marc J" sort="Gunter, Marc J" uniqKey="Gunter M" first="Marc J" last="Gunter">Marc J. Gunter</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Fortner, Renee T" sort="Fortner, Renee T" uniqKey="Fortner R" first="Renée T" last="Fortner">Renée T. Fortner</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)</institution>, Im Neuenheimer Feld 280, Heidelberg 69120,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tsilidis, Konstantinos K" sort="Tsilidis, Konstantinos K" uniqKey="Tsilidis K" first="Konstantinos K" last="Tsilidis">Konstantinos K. Tsilidis</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff3"><institution>Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus</institution>, Ioannina 45110,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Weiderpass, Elisabete" sort="Weiderpass, Elisabete" uniqKey="Weiderpass E" first="Elisabete" last="Weiderpass">Elisabete Weiderpass</name><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway</institution>, Tromsø N–9037,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff5"><institution>Department of Research, Cancer Registry of Norway</institution>, PB 5313 Majorstuen, 0304 Oslo,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff6"><institution>Department of Medical Epidemiology and Biostatistics, Karolinska Institutet</institution>, PO Box 281, Stockholm 17177,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff7"><institution>Genetic Epidemiology Group, Folkhälsan Research Center</institution>, FI-00290 Helsinki,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Charlotte Onland Moret, N" sort="Charlotte Onland Moret, N" uniqKey="Charlotte Onland Moret N" first="N" last="Charlotte Onland-Moret">N. Charlotte Onland-Moret</name><affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht</institution>, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dossus, Laure" sort="Dossus, Laure" uniqKey="Dossus L" first="Laure" last="Dossus">Laure Dossus</name><affiliation wicri:level="1"><nlm:aff id="aff9"><institution>Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10"><institution>Université Paris Sud, UMRS 1018</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff11"><institution>Institut Gustave Roussy</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tj Nneland, Anne" sort="Tj Nneland, Anne" uniqKey="Tj Nneland A" first="Anne" last="Tj Nneland">Anne Tj Nneland</name><affiliation wicri:level="1"><nlm:aff id="aff12"><institution>Danish Cancer Society Research Center</institution>, Strandboulevarden 49, Copenhagen DK-2100,<country>Denmark</country></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Hansen, Louise" sort="Hansen, Louise" uniqKey="Hansen L" first="Louise" last="Hansen">Louise Hansen</name><affiliation wicri:level="1"><nlm:aff id="aff12"><institution>Danish Cancer Society Research Center</institution>, Strandboulevarden 49, Copenhagen DK-2100,<country>Denmark</country></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Overvad, Kim" sort="Overvad, Kim" uniqKey="Overvad K" first="Kim" last="Overvad">Kim Overvad</name><affiliation wicri:level="1"><nlm:aff id="aff13"><institution>Section for Epidemiology, Department of Public Health, Aarhus University</institution>, Bartholins Alle 2, Aarhus C DK-8000,<country>Denmark</country></nlm:aff><country xml:lang="fr">Danemark</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mesrine, Sylvie" sort="Mesrine, Sylvie" uniqKey="Mesrine S" first="Sylvie" last="Mesrine">Sylvie Mesrine</name><affiliation wicri:level="1"><nlm:aff id="aff9"><institution>Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10"><institution>Université Paris Sud, UMRS 1018</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff11"><institution>Institut Gustave Roussy</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Baglietto, Laura" sort="Baglietto, Laura" uniqKey="Baglietto L" first="Laura" last="Baglietto">Laura Baglietto</name><affiliation wicri:level="1"><nlm:aff id="aff14"><institution>Cancer Epidemiology Center, Cancer Council of Victoria</institution>, 615 St Kilda Road, Melbourne 3004, Victoria,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff15"><institution>Center for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne</institution>, Melbourne 3010, Victoria,<country>Australia</country></nlm:aff><country xml:lang="fr">Australie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Clavel Chapelon, Francoise" sort="Clavel Chapelon, Francoise" uniqKey="Clavel Chapelon F" first="Françoise" last="Clavel-Chapelon">Françoise Clavel-Chapelon</name><affiliation wicri:level="1"><nlm:aff id="aff9"><institution>Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff10"><institution>Université Paris Sud, UMRS 1018</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff11"><institution>Institut Gustave Roussy</institution>, Villejuif F-94805,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kaaks, Rudolf" sort="Kaaks, Rudolf" uniqKey="Kaaks R" first="Rudolf" last="Kaaks">Rudolf Kaaks</name><affiliation wicri:level="1"><nlm:aff id="aff2"><institution>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)</institution>, Im Neuenheimer Feld 280, Heidelberg 69120,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Aleksandrova, Krasimira" sort="Aleksandrova, Krasimira" uniqKey="Aleksandrova K" first="Krasimira" last="Aleksandrova">Krasimira Aleksandrova</name><affiliation wicri:level="1"><nlm:aff id="aff16"><institution>Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke</institution>, Arthur-Scheunert-Allee 114–116, Nuthetal 14558,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Boeing, Heiner" sort="Boeing, Heiner" uniqKey="Boeing H" first="Heiner" last="Boeing">Heiner Boeing</name><affiliation wicri:level="1"><nlm:aff id="aff16"><institution>Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke</institution>, Arthur-Scheunert-Allee 114–116, Nuthetal 14558,<country>Germany</country></nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Trichopoulou, Antonia" sort="Trichopoulou, Antonia" uniqKey="Trichopoulou A" first="Antonia" last="Trichopoulou">Antonia Trichopoulou</name><affiliation wicri:level="1"><nlm:aff id="aff17"><institution>Hellenic Health Foundation</institution>, 13 Kaisareias Street, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff18"><institution>Bureau of Epidemiologic Research, Academy of Athens</institution>, 23 Alexandroupoleos Street, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lagiou, Pagona" sort="Lagiou, Pagona" uniqKey="Lagiou P" first="Pagona" last="Lagiou">Pagona Lagiou</name><affiliation wicri:level="1"><nlm:aff id="aff19"> Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115,<country>USA</country></nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff20"><institution>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School</institution>, Mikras Asias 75, Goudi, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bamia, Christina" sort="Bamia, Christina" uniqKey="Bamia C" first="Christina" last="Bamia">Christina Bamia</name><affiliation wicri:level="1"><nlm:aff id="aff20"><institution>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School</institution>, Mikras Asias 75, Goudi, Athens GR-115 27,<country>Greece</country></nlm:aff><country xml:lang="fr">Grèce</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Masala, Giovanna" sort="Masala, Giovanna" uniqKey="Masala G" first="Giovanna" last="Masala">Giovanna Masala</name><affiliation wicri:level="1"><nlm:aff id="aff21"><institution>Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO</institution>, Ponte Nuovo Palazzina 28A ‘Mario Fiori', Via delle Oblate 4, Florence 50141,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Agnoli, Claudia" sort="Agnoli, Claudia" uniqKey="Agnoli C" first="Claudia" last="Agnoli">Claudia Agnoli</name><affiliation wicri:level="1"><nlm:aff id="aff22"><institution>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori</institution>, Via Venezian, 1, Milano 20133,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Tumino, Rosario" sort="Tumino, Rosario" uniqKey="Tumino R" first="Rosario" last="Tumino">Rosario Tumino</name><affiliation wicri:level="1"><nlm:aff id="aff23"><institution>Cancer Registry and Histopathology Unit, ‘Civic–M.P. Arezzo' Hospital, ASP</institution>, Via Dante No. 109, Ragusa 97100,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ricceri, Fulvio" sort="Ricceri, Fulvio" uniqKey="Ricceri F" first="Fulvio" last="Ricceri">Fulvio Ricceri</name><affiliation wicri:level="1"><nlm:aff id="aff24"><institution>Unit of Epidemiology, Regional Health Service ASL TO3</institution>, Via Sabaudia 164, Grugliasco (TO) 10095,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff25"><institution>Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin</institution>, Via Santena 7, Turin 10126,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Panico, Salvatore" sort="Panico, Salvatore" uniqKey="Panico S" first="Salvatore" last="Panico">Salvatore Panico</name><affiliation wicri:level="1"><nlm:aff id="aff26"><institution>Dipartimento di Medicina Clinica e Chirurgia, Federico II University</institution>, via Pansini 5, 80131 Naples,<country>Italy</country></nlm:aff><country xml:lang="fr">Italie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Bueno De Mesquita, Hb As" sort="Bueno De Mesquita, Hb As" uniqKey="Bueno De Mesquita H" first="Hb As" last="Bueno-De-Mesquita">Hb As Bueno-De-Mesquita</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff27"><institution>Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM)</institution>, PO Box 1, Bilthoven 3720 BA,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff28"><institution>Department of Gastroenterology and Hepatology, University Medical Center Utrecht</institution>, Heidelberglann 100, Utrecht 3584 cx,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff29"><institution>Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya</institution>, Kuala Lumpur 50603,<country>Malaysia</country></nlm:aff><country xml:lang="fr">Malaisie</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Peeters, Petra H" sort="Peeters, Petra H" uniqKey="Peeters P" first="Petra H" last="Peeters">Petra H. Peeters</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff8"><institution>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht</institution>, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA,<country>The Netherlands</country></nlm:aff><country xml:lang="fr">Pays-Bas</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Jareid, Mie" sort="Jareid, Mie" uniqKey="Jareid M" first="Mie" last="Jareid">Mie Jareid</name><affiliation wicri:level="1"><nlm:aff id="aff4"><institution>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway</institution>, Tromsø N–9037,<country>Norway</country></nlm:aff><country xml:lang="fr">Norvège</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ram N Quir S, J" sort="Ram N Quir S, J" uniqKey="Ram N Quir S J" first="J" last="Ram N Quir S">J. Ram N Quir S</name><affiliation wicri:level="1"><nlm:aff id="aff30"><institution>Public Health Directorate, Asturias</institution>, Ciriaco Miguel Vigil St 9, Oviedo 33006,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Duell, Eric J" sort="Duell, Eric J" uniqKey="Duell E" first="Eric J" last="Duell">Eric J. Duell</name><affiliation wicri:level="1"><nlm:aff id="aff31"><institution>Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL)</institution>, Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sanchez, Maria Jose" sort="Sanchez, Maria Jose" uniqKey="Sanchez M" first="María-José" last="Sánchez">María-José Sánchez</name><affiliation wicri:level="1"><nlm:aff id="aff32"><institution>Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio</institution>, 4, Campus Universitario de Cartuja, Granada 18080,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Larra Aga, Nerea" sort="Larra Aga, Nerea" uniqKey="Larra Aga N" first="Nerea" last="Larra Aga">Nerea Larra Aga</name><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff34"><institution>Public Health Division of Gipuzkoa, Regional Government of the Basque Country</institution>, Donostia,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Chirlaque, Maria Dolores" sort="Chirlaque, Maria Dolores" uniqKey="Chirlaque M" first="María-Dolores" last="Chirlaque">María-Dolores Chirlaque</name><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff35"><institution>Department of Epidemiology, Murcia Regional Health Council, IMIB–Arrixaca</institution>, Ronda de Levante 11, Murcia 30008,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Barricarte, Aurelio" sort="Barricarte, Aurelio" uniqKey="Barricarte A" first="Aurelio" last="Barricarte">Aurelio Barricarte</name><affiliation wicri:level="1"><nlm:aff id="aff33"><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff36"><institution>Navarra Public Health Institute</institution>, c/Leyre 15, Pamplona 31003,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff37"><institution>IdiSNA, Navarra Institute for Health Research</institution>, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona 31008,<country>Spain</country></nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Dias, Joana A" sort="Dias, Joana A" uniqKey="Dias J" first="Joana A" last="Dias">Joana A. Dias</name><affiliation wicri:level="1"><nlm:aff id="aff38"><institution>Department of Clinical Sciences Malmö, Lund University</institution>, Malmö 20502,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Sonestedt, Emily" sort="Sonestedt, Emily" uniqKey="Sonestedt E" first="Emily" last="Sonestedt">Emily Sonestedt</name><affiliation wicri:level="1"><nlm:aff id="aff38"><institution>Department of Clinical Sciences Malmö, Lund University</institution>, Malmö 20502,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Idahl, Annika" sort="Idahl, Annika" uniqKey="Idahl A" first="Annika" last="Idahl">Annika Idahl</name><affiliation wicri:level="1"><nlm:aff id="aff39"><institution>Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University</institution>, SE-901 87 Umeå,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="aff40"><institution>Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University</institution>, SE-901 87 Umeå,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Lundin, Eva" sort="Lundin, Eva" uniqKey="Lundin E" first="Eva" last="Lundin">Eva Lundin</name><affiliation wicri:level="1"><nlm:aff id="aff41"><institution>Department of Medical Biosciences and Pathology, Umeå University</institution>, Umeå SE-901 87,<country>Sweden</country></nlm:aff><country xml:lang="fr">Suède</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Wareham, Nicholas J" sort="Wareham, Nicholas J" uniqKey="Wareham N" first="Nicholas J" last="Wareham">Nicholas J. Wareham</name><affiliation wicri:level="1"><nlm:aff id="aff42"><institution>MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital</institution>, Hills Road, Cambridge CB2 0QQ,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Khaw, Kay Tee" sort="Khaw, Kay Tee" uniqKey="Khaw K" first="Kay-Tee" last="Khaw">Kay-Tee Khaw</name><affiliation wicri:level="1"><nlm:aff id="aff43"><institution>School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital</institution>, Hills Rd, Cambridge CB2 0SP,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Travis, Ruth C" sort="Travis, Ruth C" uniqKey="Travis R" first="Ruth C" last="Travis">Ruth C. Travis</name><affiliation wicri:level="1"><nlm:aff id="aff44"><institution>Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford</institution>, Richard Doll Building, Oxford OX3 7LF,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Rinaldi, Sabina" sort="Rinaldi, Sabina" uniqKey="Rinaldi S" first="Sabina" last="Rinaldi">Sabina Rinaldi</name><affiliation wicri:level="1"><nlm:aff id="aff45"><institution>International Agency for Research on Cancer</institution>, 150 Cours Albert-Thomas, Lyon Cedex 08 69372,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Romieu, Isabelle" sort="Romieu, Isabelle" uniqKey="Romieu I" first="Isabelle" last="Romieu">Isabelle Romieu</name><affiliation wicri:level="1"><nlm:aff id="aff45"><institution>International Agency for Research on Cancer</institution>, 150 Cours Albert-Thomas, Lyon Cedex 08 69372,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Riboli, Elio" sort="Riboli, Elio" uniqKey="Riboli E" first="Elio" last="Riboli">Elio Riboli</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Merritt, Melissa A" sort="Merritt, Melissa A" uniqKey="Merritt M" first="Melissa A" last="Merritt">Melissa A. Merritt</name><affiliation wicri:level="1"><nlm:aff id="aff1"><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">British Journal of Cancer</title><idno type="ISSN">0007-0920</idno><idno type="eISSN">1532-1827</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background:</title><p>Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25–70 years at recruitment from 1992 to 2000.</p></sec><sec><title>Methods:</title><p>Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.</p></sec><sec><title>Results:</title><p>After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever <italic>vs</italic> never use, HR=0.80, 95% CI=0.62–1.03) and a significant survival benefit in long-term MHT users (⩾5 years use <italic>vs</italic> never use, HR=0.70, 95% CI=0.50–0.99, <italic>P</italic><sub><italic>trend</italic></sub>=0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk.</p></sec><sec><title>Conclusions:</title><p>Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct></listBibl></div1></back></TEI><pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Br J Cancer</journal-id><journal-id journal-id-type="iso-abbrev">Br. J. Cancer</journal-id><journal-title-group><journal-title>British Journal of Cancer</journal-title></journal-title-group><issn pub-type="ppub">0007-0920</issn><issn pub-type="epub">1532-1827</issn><publisher><publisher-name>Nature Publishing Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">26554655</article-id><article-id pub-id-type="pmc">4705888</article-id><article-id pub-id-type="pii">bjc2015377</article-id><article-id pub-id-type="doi">10.1038/bjc.2015.377</article-id><article-categories><subj-group subj-group-type="heading"><subject>Epidemiology</subject></subj-group></article-categories><title-group><article-title>Reproductive factors and epithelial ovarian cancer survival in the EPIC cohort study</article-title><alt-title alt-title-type="running">Reproductive factors and ovarian cancer-specific survival</alt-title></title-group><contrib-group><contrib 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Onland-Moret</surname><given-names>N</given-names></name><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Dossus</surname><given-names>Laure</given-names></name><xref ref-type="aff" rid="aff9">9</xref><xref ref-type="aff" rid="aff10">10</xref><xref ref-type="aff" rid="aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Tjønneland</surname><given-names>Anne</given-names></name><xref ref-type="aff" rid="aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Hansen</surname><given-names>Louise</given-names></name><xref ref-type="aff" rid="aff12">12</xref></contrib><contrib contrib-type="author"><name><surname>Overvad</surname><given-names>Kim</given-names></name><xref ref-type="aff" rid="aff13">13</xref></contrib><contrib contrib-type="author"><name><surname>Mesrine</surname><given-names>Sylvie</given-names></name><xref ref-type="aff" rid="aff9">9</xref><xref ref-type="aff" rid="aff10">10</xref><xref ref-type="aff" rid="aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Baglietto</surname><given-names>Laura</given-names></name><xref ref-type="aff" rid="aff14">14</xref><xref ref-type="aff" rid="aff15">15</xref></contrib><contrib contrib-type="author"><name><surname>Clavel-Chapelon</surname><given-names>Françoise</given-names></name><xref ref-type="aff" rid="aff9">9</xref><xref ref-type="aff" rid="aff10">10</xref><xref ref-type="aff" rid="aff11">11</xref></contrib><contrib contrib-type="author"><name><surname>Kaaks</surname><given-names>Rudolf</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Aleksandrova</surname><given-names>Krasimira</given-names></name><xref ref-type="aff" rid="aff16">16</xref></contrib><contrib contrib-type="author"><name><surname>Boeing</surname><given-names>Heiner</given-names></name><xref ref-type="aff" rid="aff16">16</xref></contrib><contrib contrib-type="author"><name><surname>Trichopoulou</surname><given-names>Antonia</given-names></name><xref ref-type="aff" rid="aff17">17</xref><xref ref-type="aff" rid="aff18">18</xref></contrib><contrib contrib-type="author"><name><surname>Lagiou</surname><given-names>Pagona</given-names></name><xref ref-type="aff" rid="aff19">19</xref><xref ref-type="aff" rid="aff20">20</xref></contrib><contrib contrib-type="author"><name><surname>Bamia</surname><given-names>Christina</given-names></name><xref ref-type="aff" rid="aff20">20</xref></contrib><contrib contrib-type="author"><name><surname>Masala</surname><given-names>Giovanna</given-names></name><xref ref-type="aff" rid="aff21">21</xref></contrib><contrib contrib-type="author"><name><surname>Agnoli</surname><given-names>Claudia</given-names></name><xref ref-type="aff" rid="aff22">22</xref></contrib><contrib contrib-type="author"><name><surname>Tumino</surname><given-names>Rosario</given-names></name><xref ref-type="aff" rid="aff23">23</xref></contrib><contrib contrib-type="author"><name><surname>Ricceri</surname><given-names>Fulvio</given-names></name><xref ref-type="aff" rid="aff24">24</xref><xref ref-type="aff" rid="aff25">25</xref></contrib><contrib contrib-type="author"><name><surname>Panico</surname><given-names>Salvatore</given-names></name><xref ref-type="aff" rid="aff26">26</xref></contrib><contrib contrib-type="author"><name><surname>Bueno-de-Mesquita</surname><given-names>HB(as)</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff27">27</xref><xref ref-type="aff" rid="aff28">28</xref><xref ref-type="aff" rid="aff29">29</xref></contrib><contrib contrib-type="author"><name><surname>Peeters</surname><given-names>Petra H</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff8">8</xref></contrib><contrib contrib-type="author"><name><surname>Jareid</surname><given-names>Mie</given-names></name><xref ref-type="aff" rid="aff4">4</xref></contrib><contrib contrib-type="author"><name><surname>Ramón Quirós</surname><given-names>J</given-names></name><xref ref-type="aff" rid="aff30">30</xref></contrib><contrib contrib-type="author"><name><surname>Duell</surname><given-names>Eric J</given-names></name><xref ref-type="aff" rid="aff31">31</xref></contrib><contrib contrib-type="author"><name><surname>Sánchez</surname><given-names>María-José</given-names></name><xref ref-type="aff" rid="aff32">32</xref><xref ref-type="aff" rid="aff33">33</xref></contrib><contrib contrib-type="author"><name><surname>Larrañaga</surname><given-names>Nerea</given-names></name><xref ref-type="aff" rid="aff33">33</xref><xref ref-type="aff" rid="aff34">34</xref></contrib><contrib contrib-type="author"><name><surname>Chirlaque</surname><given-names>María-Dolores</given-names></name><xref ref-type="aff" rid="aff33">33</xref><xref ref-type="aff" rid="aff35">35</xref></contrib><contrib contrib-type="author"><name><surname>Barricarte</surname><given-names>Aurelio</given-names></name><xref ref-type="aff" rid="aff33">33</xref><xref ref-type="aff" rid="aff36">36</xref><xref ref-type="aff" rid="aff37">37</xref></contrib><contrib contrib-type="author"><name><surname>Dias</surname><given-names>Joana A</given-names></name><xref ref-type="aff" rid="aff38">38</xref></contrib><contrib contrib-type="author"><name><surname>Sonestedt</surname><given-names>Emily</given-names></name><xref ref-type="aff" rid="aff38">38</xref></contrib><contrib contrib-type="author"><name><surname>Idahl</surname><given-names>Annika</given-names></name><xref ref-type="aff" rid="aff39">39</xref><xref ref-type="aff" rid="aff40">40</xref></contrib><contrib contrib-type="author"><name><surname>Lundin</surname><given-names>Eva</given-names></name><xref ref-type="aff" rid="aff41">41</xref></contrib><contrib contrib-type="author"><name><surname>Wareham</surname><given-names>Nicholas J</given-names></name><xref ref-type="aff" rid="aff42">42</xref></contrib><contrib contrib-type="author"><name><surname>Khaw</surname><given-names>Kay-Tee</given-names></name><xref ref-type="aff" rid="aff43">43</xref></contrib><contrib contrib-type="author"><name><surname>Travis</surname><given-names>Ruth C</given-names></name><xref ref-type="aff" rid="aff44">44</xref></contrib><contrib contrib-type="author"><name><surname>Rinaldi</surname><given-names>Sabina</given-names></name><xref ref-type="aff" rid="aff45">45</xref></contrib><contrib contrib-type="author"><name><surname>Romieu</surname><given-names>Isabelle</given-names></name><xref ref-type="aff" rid="aff45">45</xref></contrib><contrib contrib-type="author"><name><surname>Riboli</surname><given-names>Elio</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Merritt</surname><given-names>Melissa A</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="author-notes" rid="note1"><sup>46</sup></xref><xref ref-type="corresp" rid="caf1">*</xref></contrib><aff id="aff1"><label>1</label><institution>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London</institution>, Norfolk Place, London W2 1PG,<country>UK</country></aff><aff id="aff2"><label>2</label><institution>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ)</institution>, Im Neuenheimer Feld 280, Heidelberg 69120,<country>Germany</country></aff><aff id="aff3"><label>3</label><institution>Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus</institution>, Ioannina 45110,<country>Greece</country></aff><aff id="aff4"><label>4</label><institution>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø–The Arctic University of Norway</institution>, Tromsø N–9037,<country>Norway</country></aff><aff id="aff5"><label>5</label><institution>Department of Research, Cancer Registry of Norway</institution>, PB 5313 Majorstuen, 0304 Oslo,<country>Norway</country></aff><aff id="aff6"><label>6</label><institution>Department of Medical Epidemiology and Biostatistics, Karolinska Institutet</institution>, PO Box 281, Stockholm 17177,<country>Sweden</country></aff><aff id="aff7"><label>7</label><institution>Genetic Epidemiology Group, Folkhälsan Research Center</institution>, FI-00290 Helsinki,<country>Finland</country></aff><aff id="aff8"><label>8</label><institution>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht</institution>, Huispost Str. 6.131, PO Box 85500, Utrecht 3508 GA,<country>The Netherlands</country></aff><aff id="aff9"><label>9</label><institution>Inserm, Center for Research in Epidemiology and Population Health (CESP), U1018, Lifestyle, Genes and Health: Integrative Trans-generational Epidemiology</institution>, Villejuif F-94805,<country>France</country></aff><aff id="aff10"><label>10</label><institution>Université Paris Sud, UMRS 1018</institution>, Villejuif F-94805,<country>France</country></aff><aff id="aff11"><label>11</label><institution>Institut Gustave Roussy</institution>, Villejuif F-94805,<country>France</country></aff><aff id="aff12"><label>12</label><institution>Danish Cancer Society Research Center</institution>, Strandboulevarden 49, Copenhagen DK-2100,<country>Denmark</country></aff><aff id="aff13"><label>13</label><institution>Section for Epidemiology, Department of Public Health, Aarhus University</institution>, Bartholins Alle 2, Aarhus C DK-8000,<country>Denmark</country></aff><aff id="aff14"><label>14</label><institution>Cancer Epidemiology Center, Cancer Council of Victoria</institution>, 615 St Kilda Road, Melbourne 3004, Victoria,<country>Australia</country></aff><aff id="aff15"><label>15</label><institution>Center for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne</institution>, Melbourne 3010, Victoria,<country>Australia</country></aff><aff id="aff16"><label>16</label><institution>Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke</institution>, Arthur-Scheunert-Allee 114–116, Nuthetal 14558,<country>Germany</country></aff><aff id="aff17"><label>17</label><institution>Hellenic Health Foundation</institution>, 13 Kaisareias Street, Athens GR-115 27,<country>Greece</country></aff><aff id="aff18"><label>18</label><institution>Bureau of Epidemiologic Research, Academy of Athens</institution>, 23 Alexandroupoleos Street, Athens GR-115 27,<country>Greece</country></aff><aff id="aff19"><label>19</label> Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115,<country>USA</country></aff><aff id="aff20"><label>20</label><institution>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School</institution>, Mikras Asias 75, Goudi, Athens GR-115 27,<country>Greece</country></aff><aff id="aff21"><label>21</label><institution>Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute–ISPO</institution>, Ponte Nuovo Palazzina 28A ‘Mario Fiori', Via delle Oblate 4, Florence 50141,<country>Italy</country></aff><aff id="aff22"><label>22</label><institution>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori</institution>, Via Venezian, 1, Milano 20133,<country>Italy</country></aff><aff id="aff23"><label>23</label><institution>Cancer Registry and Histopathology Unit, ‘Civic–M.P. Arezzo' Hospital, ASP</institution>, Via Dante No. 109, Ragusa 97100,<country>Italy</country></aff><aff id="aff24"><label>24</label><institution>Unit of Epidemiology, Regional Health Service ASL TO3</institution>, Via Sabaudia 164, Grugliasco (TO) 10095,<country>Italy</country></aff><aff id="aff25"><label>25</label><institution>Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin</institution>, Via Santena 7, Turin 10126,<country>Italy</country></aff><aff id="aff26"><label>26</label><institution>Dipartimento di Medicina Clinica e Chirurgia, Federico II University</institution>, via Pansini 5, 80131 Naples,<country>Italy</country></aff><aff id="aff27"><label>27</label><institution>Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM)</institution>, PO Box 1, Bilthoven 3720 BA,<country>The Netherlands</country></aff><aff id="aff28"><label>28</label><institution>Department of Gastroenterology and Hepatology, University Medical Center Utrecht</institution>, Heidelberglann 100, Utrecht 3584 cx,<country>The Netherlands</country></aff><aff id="aff29"><label>29</label><institution>Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya</institution>, Kuala Lumpur 50603,<country>Malaysia</country></aff><aff id="aff30"><label>30</label><institution>Public Health Directorate, Asturias</institution>, Ciriaco Miguel Vigil St 9, Oviedo 33006,<country>Spain</country></aff><aff id="aff31"><label>31</label><institution>Unit of Nutrition and Cancer, Cancer Epidemiology Research Program, Catalan Institute of Oncology (ICO-IDIBELL)</institution>, Avda Gran Via 199-203, 08908 L'Hospitalet de Llobregat, Barcelona,<country>Spain</country></aff><aff id="aff32"><label>32</label><institution>Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs, Hospitales Universitarios de Granada/Universidad de Granada, Cuesta del Observatorio</institution>, 4, Campus Universitario de Cartuja, Granada 18080,<country>Spain</country></aff><aff id="aff33"><label>33</label><institution>CIBER de Epidemiología y Salud Pública (CIBERESP)</institution>, Melchor Fernández Almagro, 3-5, Madrid 28029,<country>Spain</country></aff><aff id="aff34"><label>34</label><institution>Public Health Division of Gipuzkoa, Regional Government of the Basque Country</institution>, Donostia,<country>Spain</country></aff><aff id="aff35"><label>35</label><institution>Department of Epidemiology, Murcia Regional Health Council, IMIB–Arrixaca</institution>, Ronda de Levante 11, Murcia 30008,<country>Spain</country></aff><aff id="aff36"><label>36</label><institution>Navarra Public Health Institute</institution>, c/Leyre 15, Pamplona 31003,<country>Spain</country></aff><aff id="aff37"><label>37</label><institution>IdiSNA, Navarra Institute for Health Research</institution>, Recinto de Complejo Hospitalario de Navarra c/Irunlarrea 3, Pamplona 31008,<country>Spain</country></aff><aff id="aff38"><label>38</label><institution>Department of Clinical Sciences Malmö, Lund University</institution>, Malmö 20502,<country>Sweden</country></aff><aff id="aff39"><label>39</label><institution>Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University</institution>, SE-901 87 Umeå,<country>Sweden</country></aff><aff id="aff40"><label>40</label><institution>Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University</institution>, SE-901 87 Umeå,<country>Sweden</country></aff><aff id="aff41"><label>41</label><institution>Department of Medical Biosciences and Pathology, Umeå University</institution>, Umeå SE-901 87,<country>Sweden</country></aff><aff id="aff42"><label>42</label><institution>MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Box 285, Addenbrooke's Hospital</institution>, Hills Road, Cambridge CB2 0QQ,<country>UK</country></aff><aff id="aff43"><label>43</label><institution>School of Clinical Medicine, University of Cambridge, Addenbrooke's Hospital</institution>, Hills Rd, Cambridge CB2 0SP,<country>UK</country></aff><aff id="aff44"><label>44</label><institution>Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford</institution>, Richard Doll Building, Oxford OX3 7LF,<country>UK</country></aff><aff id="aff45"><label>45</label><institution>International Agency for Research on Cancer</institution>, 150 Cours Albert-Thomas, Lyon Cedex 08 69372,<country>France</country></aff></contrib-group><author-notes><corresp id="caf1"><label>*</label>E-mail: <email>m.merritt@imperial.ac.uk</email></corresp><fn fn-type="present-address" id="note1"><label>46</label><p>Current address: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, UK.</p></fn></author-notes><pub-date pub-type="ppub"><day>01</day><month>12</month><year>2015</year></pub-date><pub-date pub-type="epub"><day>10</day><month>11</month><year>2015</year></pub-date><volume>113</volume><issue>11</issue><fpage>1622</fpage><lpage>1631</lpage><history><date date-type="received"><day>29</day><month>07</month><year>2015</year></date><date date-type="rev-recd"><day>06</day><month>10</month><year>2015</year></date><date date-type="accepted"><day>08</day><month>10</month><year>2015</year></date></history><permissions><copyright-statement>Copyright © 2015 Cancer Research UK</copyright-statement><copyright-year>2015</copyright-year><copyright-holder>Cancer Research UK</copyright-holder><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc-sa/4.0/"><license-p>From twelve months after its original publication, this work is licensed under the Creative Commons Attribution-NonCommercial-Share Alike 4.0 Unported License. To view a copy of this license, visit <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc-sa/4.0/">http://creativecommons.org/licenses/by-nc-sa/4.0/</ext-link></license-p></license></permissions><abstract><sec><title>Background:</title><p>Reproductive factors influence the risk of developing epithelial ovarian cancer (EOC), but little is known about their association with survival. We tested whether prediagnostic reproductive factors influenced EOC-specific survival among 1025 invasive EOC cases identified in the European Prospective Investigation into Cancer and Nutrition (EPIC) study, which included 521 330 total participants (approximately 370 000 women) aged 25–70 years at recruitment from 1992 to 2000.</p></sec><sec><title>Methods:</title><p>Information on reproductive characteristics was collected at recruitment. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), and multivariable models were adjusted for age and year of diagnosis, body mass index, tumour stage, smoking status and stratified by study centre.</p></sec><sec><title>Results:</title><p>After a mean follow-up of 3.6 years (±3.2 s.d.) following EOC diagnosis, 511 (49.9%) of the 1025 women died from EOC. We observed a suggestive survival advantage in menopausal hormone therapy (MHT) users (ever <italic>vs</italic> never use, HR=0.80, 95% CI=0.62–1.03) and a significant survival benefit in long-term MHT users (⩾5 years use <italic>vs</italic> never use, HR=0.70, 95% CI=0.50–0.99, <italic>P</italic><sub><italic>trend</italic></sub>=0.04). We observed similar results for MHT use when restricting to serous cases. Other reproductive factors, including parity, breastfeeding, oral contraceptive use and age at menarche or menopause, were not associated with EOC-specific mortality risk.</p></sec><sec><title>Conclusions:</title><p>Further studies are warranted to investigate the possible improvement in EOC survival in MHT users.</p></sec></abstract><kwd-group><kwd>epithelial ovarian cancer</kwd><kwd>menopausal hormone therapy</kwd><kwd>survival</kwd><kwd>oral contraceptives</kwd><kwd>parity</kwd></kwd-group></article-meta></front><floats-group><table-wrap id="tbl1"><label>Table 1</label><caption><title>Association between clinicopathological and demographic factors in relation to survival among EOC cases</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th align="left" valign="top" charoff="50"> </th><th align="center" valign="top" charoff="50"><bold>Total</bold><xref ref-type="fn" rid="t1-fn2">a</xref><italic><bold>n</bold></italic></th><th align="center" valign="top" charoff="50"><bold>Fatal cases</bold><xref ref-type="fn" rid="t1-fn3">b</xref><italic><bold>n</bold></italic><bold>(%)</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold><xref ref-type="fn" rid="t1-fn4">c</xref></th><th align="center" valign="top" charoff="50"><bold>95% CI</bold></th></tr></thead><tbody valign="top"><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Age at diagnosis</bold><xref ref-type="fn" rid="t1-fn5">d</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50"><50</td><td align="center" valign="top" charoff="50">103</td><td align="center" valign="top" charoff="50">44 (42.7)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">50–59</td><td align="center" valign="top" charoff="50">361</td><td align="center" valign="top" charoff="50">160 (44.3)</td><td align="center" valign="top" charoff="50">1.25</td><td align="center" valign="top" charoff="50">0.88–1.79</td></tr><tr><td align="left" valign="top" charoff="50">60–69</td><td align="center" valign="top" charoff="50">411</td><td align="center" valign="top" charoff="50">218 (53.0)</td><td align="center" valign="top" charoff="50">1.68</td><td align="center" valign="top" charoff="50">1.17–2.41</td></tr><tr><td align="left" valign="top" charoff="50">70+</td><td align="center" valign="top" charoff="50">150</td><td align="center" valign="top" charoff="50">89 (59.3)</td><td align="center" valign="top" charoff="50">2.58</td><td align="center" valign="top" charoff="50">1.71–3.90</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"><0.001</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Tumour site</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Ovary</td><td align="center" valign="top" charoff="50">960</td><td align="center" valign="top" charoff="50">482 (50.2)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Other<xref ref-type="fn" rid="t1-fn6">e</xref></td><td align="center" valign="top" charoff="50">65</td><td align="center" valign="top" charoff="50">29 (44.6)</td><td align="center" valign="top" charoff="50">1.01</td><td align="center" valign="top" charoff="50">0.67–1.53</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Histology</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Serous</td><td align="center" valign="top" charoff="50">568</td><td align="center" valign="top" charoff="50">298 (52.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Mucinous</td><td align="center" valign="top" charoff="50">74</td><td align="center" valign="top" charoff="50">27 (36.5)</td><td align="center" valign="top" charoff="50">1.16</td><td align="center" valign="top" charoff="50">0.77–1.77</td></tr><tr><td align="left" valign="top" charoff="50">Endometrioid</td><td align="center" valign="top" charoff="50">126</td><td align="center" valign="top" charoff="50">39 (31.0)</td><td align="center" valign="top" charoff="50">0.53</td><td align="center" valign="top" charoff="50">0.37–0.75</td></tr><tr><td align="left" valign="top" charoff="50">Clear cell</td><td align="center" valign="top" charoff="50">49</td><td align="center" valign="top" charoff="50">13 (26.5)</td><td align="center" valign="top" charoff="50">0.82</td><td align="center" valign="top" charoff="50">0.46–1.46</td></tr><tr><td align="left" valign="top" charoff="50">NOS</td><td align="center" valign="top" charoff="50">164</td><td align="center" valign="top" charoff="50">111(67.7)</td><td align="center" valign="top" charoff="50">1.41</td><td align="center" valign="top" charoff="50">1.11–1.79</td></tr><tr><td align="left" valign="top" charoff="50">Other<xref ref-type="fn" rid="t1-fn7">f</xref></td><td align="center" valign="top" charoff="50">44</td><td align="center" valign="top" charoff="50">23 (52.3)</td><td align="center" valign="top" charoff="50">1.20</td><td align="center" valign="top" charoff="50">0.77–1.90</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Grade</bold><xref ref-type="fn" rid="t1-fn8">g</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Well differentiated</td><td align="center" valign="top" charoff="50">64</td><td align="center" valign="top" charoff="50">13 (20.3)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Moderately differentiated</td><td align="center" valign="top" charoff="50">210</td><td align="center" valign="top" charoff="50">95 (45.2)</td><td align="center" valign="top" charoff="50">1.99</td><td align="center" valign="top" charoff="50">1.07–3.70</td></tr><tr><td align="left" valign="top" charoff="50">Poorly/undifferentiated</td><td align="center" valign="top" charoff="50">345</td><td align="center" valign="top" charoff="50">193 (55.9)</td><td align="center" valign="top" charoff="50">2.41</td><td align="center" valign="top" charoff="50">1.31–4.43</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>FIGO stage</bold><xref ref-type="fn" rid="t1-fn9">h</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Stage I</td><td align="center" valign="top" charoff="50">141</td><td align="center" valign="top" charoff="50">21 (14.9)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Stage II</td><td align="center" valign="top" charoff="50">78</td><td align="center" valign="top" charoff="50">27 (34.6)</td><td align="center" valign="top" charoff="50">2.77</td><td align="center" valign="top" charoff="50">1.54–4.98</td></tr><tr><td align="left" valign="top" charoff="50">Stage III</td><td align="center" valign="top" charoff="50">300</td><td align="center" valign="top" charoff="50">176 (58.7)</td><td align="center" valign="top" charoff="50">6.34</td><td align="center" valign="top" charoff="50">3.96–10.17</td></tr><tr><td align="left" valign="top" charoff="50">Stage IV</td><td align="center" valign="top" charoff="50">101</td><td align="center" valign="top" charoff="50">61 (60.4)</td><td align="center" valign="top" charoff="50">10.54</td><td align="center" valign="top" charoff="50">6.16–18.03</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Stage</bold><xref ref-type="fn" rid="t1-fn10">i</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Local</td><td align="center" valign="top" charoff="50">138</td><td align="center" valign="top" charoff="50">18 (13.0)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Regional</td><td align="center" valign="top" charoff="50">171</td><td align="center" valign="top" charoff="50">62 (36.3)</td><td align="center" valign="top" charoff="50">3.31</td><td align="center" valign="top" charoff="50">1.94–5.64</td></tr><tr><td align="left" valign="top" charoff="50">Metastatic</td><td align="center" valign="top" charoff="50">586</td><td align="center" valign="top" charoff="50">360 (61.4)</td><td align="center" valign="top" charoff="50">8.64</td><td align="center" valign="top" charoff="50">5.32–14.04</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Body mass index, kg m</bold><sup><bold>−2</bold></sup><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50"><23</td><td align="center" valign="top" charoff="50">318</td><td align="center" valign="top" charoff="50">149 (46.9)</td><td align="center" valign="top" charoff="50">0.99</td><td align="center" valign="top" charoff="50">0.76–1.28</td></tr><tr><td align="left" valign="top" charoff="50">23–24.9</td><td align="center" valign="top" charoff="50">235</td><td align="center" valign="top" charoff="50">114 (48.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">25–29.9</td><td align="center" valign="top" charoff="50">316</td><td align="center" valign="top" charoff="50">169 (53.5)</td><td align="center" valign="top" charoff="50">1.01</td><td align="center" valign="top" charoff="50">(0.79–1.30)</td></tr><tr><td align="left" valign="top" charoff="50">30+</td><td align="center" valign="top" charoff="50">156</td><td align="center" valign="top" charoff="50">79 (50.6)</td><td align="center" valign="top" charoff="50">0.85</td><td align="center" valign="top" charoff="50">(0.62–1.16)</td></tr><tr><td colspan="5" align="left" valign="top" charoff="50"><bold>Smoking status</bold><xref ref-type="fn" rid="t1-fn11">j</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never smoker</td><td align="center" valign="top" charoff="50">567</td><td align="center" valign="top" charoff="50">285 (50.3)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Former smoker</td><td align="center" valign="top" charoff="50">235</td><td align="center" valign="top" charoff="50">113 (48.1)</td><td align="center" valign="top" charoff="50">1.09</td><td align="center" valign="top" charoff="50">(0.86–1.37)</td></tr><tr><td align="left" valign="top" charoff="50">Current smoker</td><td align="center" valign="top" charoff="50">204</td><td align="center" valign="top" charoff="50">104 (51.0)</td><td align="center" valign="top" charoff="50">1.56</td><td align="center" valign="top" charoff="50">(1.22–1.99)</td></tr></tbody></table><table-wrap-foot><fn id="t1-fn1"><p>Abbreviations: CI=confidence interval; EOC=epithelial ovarian cancer; FIGO=International Federation of Gynecology and Obstetrics; HR=hazard ratio; NOS=not otherwise specified.</p></fn><fn id="t1-fn2"><label>a</label><p>Total number of cases <italic>n</italic>=1025.</p></fn><fn id="t1-fn3"><label>b</label><p>Total number of fatal cases <italic>n</italic>=511.</p></fn><fn id="t1-fn4"><label>c</label><p>Adjusted for age at diagnosis (continuous), year of diagnosis (continuous), BMI (<23 kg m<sup>−2</sup>, ⩾23–<25 (reference), ⩾25 –<30, ⩾30), tumour stage (local (reference), regional, metastatic and unknown), smoking status (never (reference), former, current and unknown) and stratified by study centre.</p></fn><fn id="t1-fn5"><label>d</label><p>Adjusted for all factors mentioned above in footnote c except for age at diagnosis as this was the variable of interest.</p></fn><fn id="t1-fn6"><label>e</label><p>Includes fallopian tube and primary peritoneal carcinomas.</p></fn><fn id="t1-fn7"><label>f</label><p>The ‘other' histological subtype category included ‘Neoplasm, malignant' (31.8%), ‘Carcinoma, undifferentiated, NOS' (25.0%) and ‘Carcinosarcoma, NOS' (11.4%) and a small number of ‘Carcinoma, anaplastic, NOS', ‘Pseudosarcomatous carcinoma, NOS', ‘Transitional cell carcinoma, NOS', ‘Solid carcinoma, NOS', ‘Mullerian mixed tumour', ‘Mesodermal mixed tumour' and ‘Brenner tumour, malignant'.</p></fn><fn id="t1-fn8"><label>g</label><p>Grade was missing for 39.6% of the cohort.</p></fn><fn id="t1-fn9"><label>h</label><p>FIGO stage was missing for 39.5% of the cohort.</p></fn><fn id="t1-fn10"><label>i</label><p>Stage is closely related to FIGO stage but is more complete across the cohort (12.7% missing).</p></fn><fn id="t1-fn11"><label>j</label><p>Smoking status was missing for 1.9% of the cohort.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl2"><label>Table 2</label><caption><title>Association between prediagnostic reproductive factors and survival among EOC cases overall</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th align="left" valign="top" charoff="50"> </th><th align="center" valign="top" charoff="50"><bold>Total</bold><xref ref-type="fn" rid="t2-fn2">a</xref></th><th align="center" valign="top" charoff="50"><bold>Fatal cases</bold><xref ref-type="fn" rid="t2-fn3">b</xref></th><th align="center" valign="top" charoff="50"><bold>Model 1</bold></th><th align="center" valign="top" charoff="50"> </th><th align="center" valign="top" charoff="50"><bold>Model 2</bold></th><th align="center" valign="top" charoff="50"> </th></tr><tr><th align="left" valign="top" charoff="50"> </th><th align="center" valign="top" charoff="50"><italic><bold>n</bold></italic></th><th align="center" valign="top" charoff="50"><italic><bold>n</bold></italic><bold>(%)</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold><xref ref-type="fn" rid="t2-fn4">c</xref></th><th align="center" valign="top" charoff="50"><bold>95% CI</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold><xref ref-type="fn" rid="t2-fn5">d</xref></th><th align="center" valign="top" charoff="50"><bold>95% CI</bold></th></tr></thead><tbody valign="top"><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Age at menarche</bold><xref ref-type="fn" rid="t2-fn6">e</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50"><12</td><td align="center" valign="top" charoff="50">158</td><td align="center" valign="top" charoff="50">83 (52.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">12</td><td align="center" valign="top" charoff="50">187</td><td align="center" valign="top" charoff="50">86 (46.0)</td><td align="center" valign="top" charoff="50">0.89</td><td align="center" valign="top" charoff="50">0.65–1.22</td><td align="center" valign="top" charoff="50">1.01</td><td align="center" valign="top" charoff="50">0.74–1.38</td></tr><tr><td align="left" valign="top" charoff="50">13</td><td align="center" valign="top" charoff="50">253</td><td align="center" valign="top" charoff="50">125 (49.4)</td><td align="center" valign="top" charoff="50">0.91</td><td align="center" valign="top" charoff="50">0.68–1.22</td><td align="center" valign="top" charoff="50">0.84</td><td align="center" valign="top" charoff="50">0.63–1.13</td></tr><tr><td align="left" valign="top" charoff="50">14</td><td align="center" valign="top" charoff="50">223</td><td align="center" valign="top" charoff="50">107 (48.0)</td><td align="center" valign="top" charoff="50">0.84</td><td align="center" valign="top" charoff="50">0.62–1.13</td><td align="center" valign="top" charoff="50">0.75</td><td align="center" valign="top" charoff="50">0.55–1.01</td></tr><tr><td align="left" valign="top" charoff="50">>14</td><td align="center" valign="top" charoff="50">186</td><td align="center" valign="top" charoff="50">100 (53.8)</td><td align="center" valign="top" charoff="50">0.93</td><td align="center" valign="top" charoff="50">0.68–1.27</td><td align="center" valign="top" charoff="50">0.90</td><td align="center" valign="top" charoff="50">0.66–1.24</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.76</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.37</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Parous</bold><xref ref-type="fn" rid="t2-fn6">e</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">No</td><td align="center" valign="top" charoff="50">169</td><td align="center" valign="top" charoff="50">86 (50.9)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Yes</td><td align="center" valign="top" charoff="50">833</td><td align="center" valign="top" charoff="50">414 (49.7)</td><td align="center" valign="top" charoff="50">0.97</td><td align="center" valign="top" charoff="50">0.77–1.24</td><td align="center" valign="top" charoff="50">0.90</td><td align="center" valign="top" charoff="50">0.71–1.14</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Number of FTPs</bold><xref ref-type="fn" rid="t2-fn6">e,</xref><xref ref-type="fn" rid="t2-fn7">f</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">1</td><td align="center" valign="top" charoff="50">159</td><td align="center" valign="top" charoff="50">75 (47.2)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">2</td><td align="center" valign="top" charoff="50">394</td><td align="center" valign="top" charoff="50">190 (48.2)</td><td align="center" valign="top" charoff="50">1.07</td><td align="center" valign="top" charoff="50">0.81–1.41</td><td align="center" valign="top" charoff="50">1.04</td><td align="center" valign="top" charoff="50">0.78–1.38</td></tr><tr><td align="left" valign="top" charoff="50">3+</td><td align="center" valign="top" charoff="50">262</td><td align="center" valign="top" charoff="50">142 (54.2)</td><td align="center" valign="top" charoff="50">1.17</td><td align="center" valign="top" charoff="50">0.88–1.57</td><td align="center" valign="top" charoff="50">1.10</td><td align="center" valign="top" charoff="50">0.81–1.49</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.13</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.31</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Age at first FTP</bold><xref ref-type="fn" rid="t2-fn6">e,</xref><xref ref-type="fn" rid="t2-fn7">f</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽20</td><td align="center" valign="top" charoff="50">118</td><td align="center" valign="top" charoff="50">66 (55.9)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>20–⩽25</td><td align="center" valign="top" charoff="50">376</td><td align="center" valign="top" charoff="50">167 (44.4)</td><td align="center" valign="top" charoff="50">0.65</td><td align="center" valign="top" charoff="50">0.48–0.87</td><td align="center" valign="top" charoff="50">0.66</td><td align="center" valign="top" charoff="50">0.49–0.90</td></tr><tr><td align="left" valign="top" charoff="50">>25–⩽30</td><td align="center" valign="top" charoff="50">244</td><td align="center" valign="top" charoff="50">125 (51.2)</td><td align="center" valign="top" charoff="50">0.72</td><td align="center" valign="top" charoff="50">0.53–0.99</td><td align="center" valign="top" charoff="50">0.72</td><td align="center" valign="top" charoff="50">0.52–1.00</td></tr><tr><td align="left" valign="top" charoff="50">>30</td><td align="center" valign="top" charoff="50">88</td><td align="center" valign="top" charoff="50">52 (59.1)</td><td align="center" valign="top" charoff="50">0.87</td><td align="center" valign="top" charoff="50">0.59–1.26</td><td align="center" valign="top" charoff="50">0.86</td><td align="center" valign="top" charoff="50">0.58–1.28</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.70</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.59</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Breastfeeding</bold><xref ref-type="fn" rid="t2-fn7">f,</xref><xref ref-type="fn" rid="t2-fn8">g</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never</td><td align="center" valign="top" charoff="50">120</td><td align="center" valign="top" charoff="50">59 (49.2)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Ever</td><td align="center" valign="top" charoff="50">660</td><td align="center" valign="top" charoff="50">327 (49.5)</td><td align="center" valign="top" charoff="50">0.82</td><td align="center" valign="top" charoff="50">0.61–1.11</td><td align="center" valign="top" charoff="50">0.83</td><td align="center" valign="top" charoff="50">0.61–1.12</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Duration of breastfeeding</bold><xref ref-type="fn" rid="t2-fn6">e,</xref><xref ref-type="fn" rid="t2-fn9">h</xref><bold>, months</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽3</td><td align="center" valign="top" charoff="50">205</td><td align="center" valign="top" charoff="50">104 (50.7)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>3–⩽6</td><td align="center" valign="top" charoff="50">122</td><td align="center" valign="top" charoff="50">58 (47.5)</td><td align="center" valign="top" charoff="50">0.88</td><td align="center" valign="top" charoff="50">0.62–1.23</td><td align="center" valign="top" charoff="50">1.02</td><td align="center" valign="top" charoff="50">0.71–1.45</td></tr><tr><td align="left" valign="top" charoff="50">>6–⩽12</td><td align="center" valign="top" charoff="50">156</td><td align="center" valign="top" charoff="50">75 (48.1)</td><td align="center" valign="top" charoff="50">0.76</td><td align="center" valign="top" charoff="50">0.55–1.04</td><td align="center" valign="top" charoff="50">0.88</td><td align="center" valign="top" charoff="50">0.63–1.22</td></tr><tr><td align="left" valign="top" charoff="50">>12–⩽24</td><td align="center" valign="top" charoff="50">127</td><td align="center" valign="top" charoff="50">61 (48.0)</td><td align="center" valign="top" charoff="50">0.84</td><td align="center" valign="top" charoff="50">0.60–1.19</td><td align="center" valign="top" charoff="50">0.97</td><td align="center" valign="top" charoff="50">0.68–1.39</td></tr><tr><td align="left" valign="top" charoff="50">>24</td><td align="center" valign="top" charoff="50">47</td><td align="center" valign="top" charoff="50">28 (59.6)</td><td align="center" valign="top" charoff="50">1.10</td><td align="center" valign="top" charoff="50">0.69–1.73</td><td align="center" valign="top" charoff="50">1.11</td><td align="center" valign="top" charoff="50">0.69–1.79</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.90</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.87</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>OC use</bold><xref ref-type="fn" rid="t2-fn6">e</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never</td><td align="center" valign="top" charoff="50">523</td><td align="center" valign="top" charoff="50">273 (52.2)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Ever</td><td align="center" valign="top" charoff="50">495</td><td align="center" valign="top" charoff="50">232 (46.9)</td><td align="center" valign="top" charoff="50">1.04</td><td align="center" valign="top" charoff="50">0.86–1.26</td><td align="center" valign="top" charoff="50">0.96</td><td align="center" valign="top" charoff="50">0.79–1.17</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Duration of OC use</bold><xref ref-type="fn" rid="t2-fn10">i,</xref><xref ref-type="fn" rid="t2-fn11">j</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽1</td><td align="center" valign="top" charoff="50">112</td><td align="center" valign="top" charoff="50">45 (40.2)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>1–⩽5</td><td align="center" valign="top" charoff="50">164</td><td align="center" valign="top" charoff="50">71 (43.3)</td><td align="center" valign="top" charoff="50">0.88</td><td align="center" valign="top" charoff="50">0.59–1.32</td><td align="center" valign="top" charoff="50">0.98</td><td align="center" valign="top" charoff="50">0.65–1.48</td></tr><tr><td align="left" valign="top" charoff="50">>5–⩽10</td><td align="center" valign="top" charoff="50">101</td><td align="center" valign="top" charoff="50">47 (46.5)</td><td align="center" valign="top" charoff="50">1.12</td><td align="center" valign="top" charoff="50">0.72–1.74</td><td align="center" valign="top" charoff="50">1.26</td><td align="center" valign="top" charoff="50">0.80–1.98</td></tr><tr><td align="left" valign="top" charoff="50">>10</td><td align="center" valign="top" charoff="50">77</td><td align="center" valign="top" charoff="50">49 (63.6)</td><td align="center" valign="top" charoff="50">1.69</td><td align="center" valign="top" charoff="50">1.08–2.64</td><td align="center" valign="top" charoff="50">1.74</td><td align="center" valign="top" charoff="50">1.10–2.75</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.006</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.01</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Age at menopause</bold><xref ref-type="fn" rid="t2-fn12">k,</xref><xref ref-type="fn" rid="t2-fn13">l</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽45</td><td align="center" valign="top" charoff="50">89</td><td align="center" valign="top" charoff="50">52 (58.4)</td><td align="center" valign="top" charoff="50">0.94</td><td align="center" valign="top" charoff="50">0.66–1.33</td><td align="center" valign="top" charoff="50">1.06</td><td align="center" valign="top" charoff="50">0.74–1.53</td></tr><tr><td align="left" valign="top" charoff="50">>45–⩽50</td><td align="center" valign="top" charoff="50">207</td><td align="center" valign="top" charoff="50">121(58.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>50–⩽52</td><td align="center" valign="top" charoff="50">94</td><td align="center" valign="top" charoff="50">50 (53.2)</td><td align="center" valign="top" charoff="50">0.90</td><td align="center" valign="top" charoff="50">0.64–1.27</td><td align="center" valign="top" charoff="50">0.98</td><td align="center" valign="top" charoff="50">0.69–1.40</td></tr><tr><td align="left" valign="top" charoff="50">>52</td><td align="center" valign="top" charoff="50">136</td><td align="center" valign="top" charoff="50">77 (56.6)</td><td align="center" valign="top" charoff="50">0.90</td><td align="center" valign="top" charoff="50">0.66–1.22</td><td align="center" valign="top" charoff="50">1.04</td><td align="center" valign="top" charoff="50">0.76–1.41</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.91</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.71</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT use</bold><xref ref-type="fn" rid="t2-fn6">e,</xref><xref ref-type="fn" rid="t2-fn12">k,</xref><xref ref-type="fn" rid="t2-fn14">m</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never</td><td align="center" valign="top" charoff="50">299</td><td align="center" valign="top" charoff="50">176 (58.9)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Ever</td><td align="center" valign="top" charoff="50">233</td><td align="center" valign="top" charoff="50">130 (55.8)</td><td align="center" valign="top" charoff="50">0.85</td><td align="center" valign="top" charoff="50">0.66–1.09</td><td align="center" valign="top" charoff="50">0.80</td><td align="center" valign="top" charoff="50">0.62–1.03</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT timing of use at baseline</bold><xref ref-type="fn" rid="t2-fn6">e,</xref><xref ref-type="fn" rid="t2-fn12">k,</xref><xref ref-type="fn" rid="t2-fn14">m</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Former</td><td align="center" valign="top" charoff="50">69</td><td align="center" valign="top" charoff="50">41 (59.4)</td><td align="center" valign="top" charoff="50">0.94</td><td align="center" valign="top" charoff="50">0.66–1.33</td><td align="center" valign="top" charoff="50">0.85</td><td align="center" valign="top" charoff="50">0.59–1.22</td></tr><tr><td align="left" valign="top" charoff="50">Current</td><td align="center" valign="top" charoff="50">160</td><td align="center" valign="top" charoff="50">88 (55.0)</td><td align="center" valign="top" charoff="50">0.84</td><td align="center" valign="top" charoff="50">0.63–1.12</td><td align="center" valign="top" charoff="50">0.79</td><td align="center" valign="top" charoff="50">0.59–1.06</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT duration of use at baseline</bold><xref ref-type="fn" rid="t2-fn12">k,</xref><xref ref-type="fn" rid="t2-fn14">m,</xref><xref ref-type="fn" rid="t2-fn15">n</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50"><5</td><td align="center" valign="top" charoff="50">121</td><td align="center" valign="top" charoff="50">68 (56.2)</td><td align="center" valign="top" charoff="50">0.99</td><td align="center" valign="top" charoff="50">0.73–1.34</td><td align="center" valign="top" charoff="50">0.95</td><td align="center" valign="top" charoff="50">0.69–1.29</td></tr><tr><td align="left" valign="top" charoff="50">⩾5</td><td align="center" valign="top" charoff="50">86</td><td align="center" valign="top" charoff="50">49 (57.0)</td><td align="center" valign="top" charoff="50">0.76</td><td align="center" valign="top" charoff="50">0.54–1.07</td><td align="center" valign="top" charoff="50">0.70</td><td align="center" valign="top" charoff="50">0.50–0.99</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.11</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.04</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT formulation at baseline (current users only)</bold><xref ref-type="fn" rid="t2-fn12">k,</xref><xref ref-type="fn" rid="t2-fn14">m,</xref><xref ref-type="fn" rid="t2-fn16">o</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">E only</td><td align="center" valign="top" charoff="50">37</td><td align="center" valign="top" charoff="50">24 (64.9)</td><td align="center" valign="top" charoff="50">0.84</td><td align="center" valign="top" charoff="50">0.54–1.31</td><td align="center" valign="top" charoff="50">0.86</td><td align="center" valign="top" charoff="50">0.54–1.35</td></tr><tr><td align="left" valign="top" charoff="50">E+P</td><td align="center" valign="top" charoff="50">100</td><td align="center" valign="top" charoff="50">52 (52.0)</td><td align="center" valign="top" charoff="50">0.89</td><td align="center" valign="top" charoff="50">0.62–1.27</td><td align="center" valign="top" charoff="50">0.80</td><td align="center" valign="top" charoff="50">0.55–1.16</td></tr><tr><td align="left" valign="top" charoff="50">Other</td><td align="center" valign="top" charoff="50">12</td><td align="center" valign="top" charoff="50">8 (66.7)</td><td align="center" valign="top" charoff="50">1.08</td><td align="center" valign="top" charoff="50">0.50–2.33</td><td align="center" valign="top" charoff="50">0.92</td><td align="center" valign="top" charoff="50">0.42–2.01</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Hysterectomy</bold><xref ref-type="fn" rid="t2-fn17">p</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">No</td><td align="center" valign="top" charoff="50">831</td><td align="center" valign="top" charoff="50">411 (49.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Yes</td><td align="center" valign="top" charoff="50">88</td><td align="center" valign="top" charoff="50">45 (51.1)</td><td align="center" valign="top" charoff="50">0.75</td><td align="center" valign="top" charoff="50">0.54–1.04</td><td align="center" valign="top" charoff="50">0.79</td><td align="center" valign="top" charoff="50">0.57–1.10</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Total ovulatory years</bold><xref ref-type="fn" rid="t2-fn18">q</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽27.5</td><td align="center" valign="top" charoff="50">212</td><td align="center" valign="top" charoff="50">105 (49.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>27.5–⩽33.0</td><td align="center" valign="top" charoff="50">207</td><td align="center" valign="top" charoff="50">99 (47.8)</td><td align="center" valign="top" charoff="50">0.87</td><td align="center" valign="top" charoff="50">0.65–1.17</td><td align="center" valign="top" charoff="50">0.91</td><td align="center" valign="top" charoff="50">0.67–1.23</td></tr><tr><td align="left" valign="top" charoff="50">>33.0–⩽36.5</td><td align="center" valign="top" charoff="50">212</td><td align="center" valign="top" charoff="50">94 (44.3)</td><td align="center" valign="top" charoff="50">0.72</td><td align="center" valign="top" charoff="50">0.53–0.96</td><td align="center" valign="top" charoff="50">0.72</td><td align="center" valign="top" charoff="50">0.53–0.97</td></tr><tr><td align="left" valign="top" charoff="50">>36.5</td><td align="center" valign="top" charoff="50">194</td><td align="center" valign="top" charoff="50">106 (54.6)</td><td align="center" valign="top" charoff="50">0.87</td><td align="center" valign="top" charoff="50">0.65–1.17</td><td align="center" valign="top" charoff="50">0.97</td><td align="center" valign="top" charoff="50">0.71–1.31</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.04</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.12</td></tr></tbody></table><table-wrap-foot><fn id="t2-fn1"><p>Abbreviations: CI=confidence interval; EOC=epithelial ovarian cancer; FTP=full term pregnancy; HR=hazard ratio; MHT=menopausal hormone therapy; OC=oral contraceptive.</p></fn><fn id="t2-fn2"><label>a</label><p>Total number of cases <italic>n</italic>=1025.</p></fn><fn id="t2-fn3"><label>b</label><p>Total number of fatal cases <italic>n</italic>=511.</p></fn><fn id="t2-fn4"><label>c</label><p>Adjusted for age at diagnosis (continuous) and stratified by study centre.</p></fn><fn id="t2-fn5"><label>d</label><p>Adjusted for age at diagnosis (continuous), year of diagnosis (continuous), BMI (<23 kg m<sup>−2</sup>, ⩾23–<25 (reference), ⩾25 –<30, ⩾30), tumour stage (local (reference), regional, metastatic and unknown), smoking status (never (reference), former, current and unknown) and stratified by study centre.</p></fn><fn id="t2-fn6"><label>e</label><p>Missing for <5% of the cohort.</p></fn><fn id="t2-fn7"><label>f</label><p>Among parous women only.</p></fn><fn id="t2-fn8"><label>g</label><p>Breastfeeding was missing for 6.4% of the cohort.</p></fn><fn id="t2-fn9"><label>h</label><p>Among parous women who had ever breastfed.</p></fn><fn id="t2-fn10"><label>i</label><p>Among OC users only.</p></fn><fn id="t2-fn11"><label>j</label><p>Duration of OC use was missing for 8.3% of women.</p></fn><fn id="t2-fn12"><label>k</label><p>Among postmenopausal women only.</p></fn><fn id="t2-fn13"><label>l</label><p>Age at menopause was missing for 18.6% of postmenopausal women.</p></fn><fn id="t2-fn14"><label>m</label><p>Participants from Greece and Sweden were excluded from this analysis as detailed data on MHT use were unavailable.</p></fn><fn id="t2-fn15"><label>n</label><p>MHT duration was missing for 11.2% of individuals who ever used MHT.</p></fn><fn id="t2-fn16"><label>o</label><p>MHT formulation was missing for 6.9% of individuals who reported current use.</p></fn><fn id="t2-fn17"><label>p</label><p>Hysterectomy was missing for 10.3% of the cohort.</p></fn><fn id="t2-fn18"><label>q</label><p>Total ovulatory years was missing for 19.5% of the cohort.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl3"><label>Table 3</label><caption><title>Association between prediagnostic reproductive factors and survival among serous EOC cases</title></caption><table frame="hsides" rules="groups" border="1"><colgroup><col align="left"></col><col align="left"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col><col align="center"></col></colgroup><thead valign="bottom"><tr><th align="left" valign="top" charoff="50"> </th><th align="left" valign="top" charoff="50"><bold>Total</bold><xref ref-type="fn" rid="t3-fn2">a</xref></th><th align="center" valign="top" charoff="50"><bold>Fatal cases</bold><xref ref-type="fn" rid="t3-fn3">b</xref></th><th align="center" valign="top" charoff="50"><bold>Model 1</bold></th><th align="center" valign="top" charoff="50"> </th><th align="center" valign="top" charoff="50"><bold>Model 2</bold></th><th align="center" valign="top" charoff="50"> </th></tr><tr><th align="left" valign="top" charoff="50"> </th><th align="left" valign="top" charoff="50"><italic><bold>n</bold></italic></th><th align="center" valign="top" charoff="50"><italic><bold>n</bold></italic><bold>(%)</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold><xref ref-type="fn" rid="t3-fn4">c</xref></th><th align="center" valign="top" charoff="50"><bold>95% CI</bold></th><th align="center" valign="top" charoff="50"><bold>HR</bold><xref ref-type="fn" rid="t3-fn5">d</xref></th><th align="center" valign="top" charoff="50"><bold>95% CI</bold></th></tr></thead><tbody valign="top"><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Age at menarche</bold><xref ref-type="fn" rid="t3-fn6">e</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50"><12</td><td align="char" valign="top" char="." charoff="50">84</td><td align="center" valign="top" charoff="50">48 (57.1)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">12</td><td align="char" valign="top" char="." charoff="50">102</td><td align="center" valign="top" charoff="50">50 (49.0)</td><td align="char" valign="top" char="." charoff="50">0.98</td><td align="center" valign="top" charoff="50">0.64–1.51</td><td align="char" valign="top" char="." charoff="50">1.10</td><td align="center" valign="top" charoff="50">0.71–1.69</td></tr><tr><td align="left" valign="top" charoff="50">13</td><td align="char" valign="top" char="." charoff="50">145</td><td align="center" valign="top" charoff="50">76 (52.4)</td><td align="char" valign="top" char="." charoff="50">0.92</td><td align="center" valign="top" charoff="50">0.62–1.38</td><td align="char" valign="top" char="." charoff="50">0.82</td><td align="center" valign="top" charoff="50">0.55–1.23</td></tr><tr><td align="left" valign="top" charoff="50">14</td><td align="char" valign="top" char="." charoff="50">134</td><td align="center" valign="top" charoff="50">67 (50.0)</td><td align="char" valign="top" char="." charoff="50">0.86</td><td align="center" valign="top" charoff="50">0.58–1.30</td><td align="char" valign="top" char="." charoff="50">0.79</td><td align="center" valign="top" charoff="50">0.52–1.20</td></tr><tr><td align="left" valign="top" charoff="50">>14</td><td align="char" valign="top" char="." charoff="50">98</td><td align="center" valign="top" charoff="50">54 (55.1)</td><td align="char" valign="top" char="." charoff="50">1.02</td><td align="center" valign="top" charoff="50">0.66–1.57</td><td align="char" valign="top" char="." charoff="50">0.92</td><td align="center" valign="top" charoff="50">0.59–1.44</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.80</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.69</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Parous</bold><xref ref-type="fn" rid="t3-fn6">e</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">No</td><td align="char" valign="top" char="." charoff="50">86</td><td align="center" valign="top" charoff="50">49 (57.0)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Yes</td><td align="char" valign="top" char="." charoff="50">474</td><td align="center" valign="top" charoff="50">245 (51.7)</td><td align="char" valign="top" char="." charoff="50">0.94</td><td align="center" valign="top" charoff="50">0.68–1.30</td><td align="char" valign="top" char="." charoff="50">0.96</td><td align="center" valign="top" charoff="50">0.69–1.33</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Number of FTPs</bold><xref ref-type="fn" rid="t3-fn6">e,</xref><xref ref-type="fn" rid="t3-fn7">f</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">1</td><td align="char" valign="top" char="." charoff="50">101</td><td align="center" valign="top" charoff="50">48 (47.5)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">2</td><td align="char" valign="top" char="." charoff="50">215</td><td align="center" valign="top" charoff="50">109 (50.7)</td><td align="char" valign="top" char="." charoff="50">1.22</td><td align="center" valign="top" charoff="50">0.85–1.76</td><td align="char" valign="top" char="." charoff="50">0.95</td><td align="center" valign="top" charoff="50">0.64–1.39</td></tr><tr><td align="left" valign="top" charoff="50">3+</td><td align="char" valign="top" char="." charoff="50">148</td><td align="center" valign="top" charoff="50">82 (55.4)</td><td align="char" valign="top" char="." charoff="50">1.47</td><td align="center" valign="top" charoff="50">1.00–2.16</td><td align="char" valign="top" char="." charoff="50">1.10</td><td align="center" valign="top" charoff="50">0.73–1.65</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.05</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.38</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Age at first FTP</bold><xref ref-type="fn" rid="t3-fn6">e,</xref><xref ref-type="fn" rid="t3-fn7">f</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽20</td><td align="char" valign="top" char="." charoff="50">61</td><td align="center" valign="top" charoff="50">31 (50.8)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>20–⩽25</td><td align="char" valign="top" char="." charoff="50">208</td><td align="center" valign="top" charoff="50">94 (45.2)</td><td align="center" valign="top" charoff="50">0.68</td><td align="center" valign="top" charoff="50">0.44–1.04</td><td align="center" valign="top" charoff="50">0.59</td><td align="center" valign="top" charoff="50">0.38–0.92</td></tr><tr><td align="left" valign="top" charoff="50">>25–⩽30</td><td align="char" valign="top" char="." charoff="50">145</td><td align="center" valign="top" charoff="50">83 (57.2)</td><td align="center" valign="top" charoff="50">0.82</td><td align="center" valign="top" charoff="50">0.53–1.28</td><td align="center" valign="top" charoff="50">0.75</td><td align="center" valign="top" charoff="50">0.47–1.20</td></tr><tr><td align="left" valign="top" charoff="50">>30</td><td align="char" valign="top" char="." charoff="50">56</td><td align="center" valign="top" charoff="50">35 (62.5)</td><td align="center" valign="top" charoff="50">0.76</td><td align="center" valign="top" charoff="50">0.45–1.28</td><td align="center" valign="top" charoff="50">0.71</td><td align="center" valign="top" charoff="50">0.40–1.23</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.65</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.75</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Breastfeeding</bold><xref ref-type="fn" rid="t3-fn7">f,</xref><xref ref-type="fn" rid="t3-fn8">g</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never</td><td align="char" valign="top" char="." charoff="50">69</td><td align="center" valign="top" charoff="50">34 (49.3)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Ever</td><td align="char" valign="top" char="." charoff="50">376</td><td align="center" valign="top" charoff="50">192 (51.1)</td><td align="char" valign="top" char="." charoff="50">0.88</td><td align="center" valign="top" charoff="50">0.59–1.31</td><td align="char" valign="top" char="." charoff="50">0.92</td><td align="center" valign="top" charoff="50">0.61–1.38</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Duration of breastfeeding</bold><xref ref-type="fn" rid="t3-fn9">h</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽3</td><td align="char" valign="top" char="." charoff="50">130</td><td align="center" valign="top" charoff="50">65 (50.0)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>3–⩽6</td><td align="char" valign="top" char="." charoff="50">75</td><td align="center" valign="top" charoff="50">39 (52.0)</td><td align="char" valign="top" char="." charoff="50">1.05</td><td align="center" valign="top" charoff="50">0.68–1.61</td><td align="char" valign="top" char="." charoff="50">1.07</td><td align="center" valign="top" charoff="50">0.68–1.69</td></tr><tr><td align="left" valign="top" charoff="50">>6–⩽12</td><td align="char" valign="top" char="." charoff="50">75</td><td align="center" valign="top" charoff="50">33 (44.0)</td><td align="char" valign="top" char="." charoff="50">0.61</td><td align="center" valign="top" charoff="50">0.38–0.98</td><td align="char" valign="top" char="." charoff="50">0.60</td><td align="center" valign="top" charoff="50">0.37–0.99</td></tr><tr><td align="left" valign="top" charoff="50">>12–⩽24</td><td align="char" valign="top" char="." charoff="50">69</td><td align="center" valign="top" charoff="50">38 (55.1)</td><td align="char" valign="top" char="." charoff="50">0.93</td><td align="center" valign="top" charoff="50">0.59–1.45</td><td align="char" valign="top" char="." charoff="50">0.90</td><td align="center" valign="top" charoff="50">0.56–1.43</td></tr><tr><td align="left" valign="top" charoff="50">>24</td><td align="char" valign="top" char="." charoff="50">27</td><td align="center" valign="top" charoff="50">17 (63.0)</td><td align="char" valign="top" char="." charoff="50">1.12</td><td align="center" valign="top" charoff="50">0.62–2.02</td><td align="char" valign="top" char="." charoff="50">1.13</td><td align="center" valign="top" charoff="50">0.61–2.08</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.59</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.48</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>OC use</bold><xref ref-type="fn" rid="t3-fn6">e</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never</td><td align="char" valign="top" char="." charoff="50">275</td><td align="center" valign="top" charoff="50">148 (53.8)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Ever</td><td align="char" valign="top" char="." charoff="50">289</td><td align="center" valign="top" charoff="50">147 (50.9)</td><td align="char" valign="top" char="." charoff="50">1.01</td><td align="center" valign="top" charoff="50">0.78–1.31</td><td align="char" valign="top" char="." charoff="50">0.95</td><td align="center" valign="top" charoff="50">0.73–1.23</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Duration of OC use</bold><xref ref-type="fn" rid="t3-fn10">i,</xref><xref ref-type="fn" rid="t3-fn11">j</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽1</td><td align="char" valign="top" char="." charoff="50">67</td><td align="center" valign="top" charoff="50">30 (44.8)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>1–⩽5</td><td align="char" valign="top" char="." charoff="50">94</td><td align="center" valign="top" charoff="50">50 (53.2)</td><td align="char" valign="top" char="." charoff="50">0.96</td><td align="center" valign="top" charoff="50">0.58–1.60</td><td align="char" valign="top" char="." charoff="50">1.05</td><td align="center" valign="top" charoff="50">0.61–1.78</td></tr><tr><td align="left" valign="top" charoff="50">>5–⩽10</td><td align="char" valign="top" char="." charoff="50">58</td><td align="center" valign="top" charoff="50">26 (44.8)</td><td align="char" valign="top" char="." charoff="50">0.92</td><td align="center" valign="top" charoff="50">0.52–1.64</td><td align="char" valign="top" char="." charoff="50">1.15</td><td align="center" valign="top" charoff="50">0.63–2.12</td></tr><tr><td align="left" valign="top" charoff="50">>10</td><td align="char" valign="top" char="." charoff="50">46</td><td align="center" valign="top" charoff="50">28 (60.9)</td><td align="char" valign="top" char="." charoff="50">1.42</td><td align="center" valign="top" charoff="50">0.80–2.51</td><td align="char" valign="top" char="." charoff="50">1.31</td><td align="center" valign="top" charoff="50">0.71–2.40</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.31</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.42</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Age at menopause</bold><xref ref-type="fn" rid="t3-fn12">k,</xref><xref ref-type="fn" rid="t3-fn13">l</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽45</td><td align="char" valign="top" char="." charoff="50">52</td><td align="center" valign="top" charoff="50">33 (63.5)</td><td align="char" valign="top" char="." charoff="50">1.26</td><td align="center" valign="top" charoff="50">0.79–2.02</td><td align="char" valign="top" char="." charoff="50">1.38</td><td align="center" valign="top" charoff="50">0.83–2.30</td></tr><tr><td align="left" valign="top" charoff="50">>45–⩽50</td><td align="char" valign="top" char="." charoff="50">112</td><td align="center" valign="top" charoff="50">65 (58.0)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>50–⩽52</td><td align="char" valign="top" char="." charoff="50">55</td><td align="center" valign="top" charoff="50">29 (52.7)</td><td align="char" valign="top" char="." charoff="50">0.98</td><td align="center" valign="top" charoff="50">0.61–1.58</td><td align="char" valign="top" char="." charoff="50">0.97</td><td align="center" valign="top" charoff="50">0.58–1.61</td></tr><tr><td align="left" valign="top" charoff="50">>52</td><td align="char" valign="top" char="." charoff="50">68</td><td align="center" valign="top" charoff="50">45 (66.2)</td><td align="char" valign="top" char="." charoff="50">1.16</td><td align="center" valign="top" charoff="50">0.77–1.77</td><td align="char" valign="top" char="." charoff="50">1.11</td><td align="center" valign="top" charoff="50">0.71–1.75</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.88</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.64</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT use</bold><xref ref-type="fn" rid="t3-fn6">e,</xref><xref ref-type="fn" rid="t3-fn12">k,</xref><xref ref-type="fn" rid="t3-fn14">m</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Never</td><td align="char" valign="top" char="." charoff="50">151</td><td align="center" valign="top" charoff="50">94 (62.3)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Ever</td><td align="char" valign="top" char="." charoff="50">144</td><td align="center" valign="top" charoff="50">80 (55.6)</td><td align="char" valign="top" char="." charoff="50">0.71</td><td align="center" valign="top" charoff="50">0.50–1.00</td><td align="char" valign="top" char="." charoff="50">0.63</td><td align="center" valign="top" charoff="50">0.44–0.90</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT timing of use at baseline</bold><xref ref-type="fn" rid="t3-fn6">e,</xref><xref ref-type="fn" rid="t3-fn12">k,</xref><xref ref-type="fn" rid="t3-fn14">m</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">Former</td><td align="left" valign="top" charoff="50">42</td><td align="center" valign="top" charoff="50">25 (59.5)</td><td align="char" valign="top" char="." charoff="50">0.86</td><td align="center" valign="top" charoff="50">0.54–1.38</td><td align="char" valign="top" char="." charoff="50">0.73</td><td align="center" valign="top" charoff="50">0.45–1.18</td></tr><tr><td align="left" valign="top" charoff="50">Current</td><td align="left" valign="top" charoff="50">101</td><td align="center" valign="top" charoff="50">54 (53.5)</td><td align="char" valign="top" char="." charoff="50">0.65</td><td align="center" valign="top" charoff="50">0.44–0.96</td><td align="char" valign="top" char="." charoff="50">0.60</td><td align="center" valign="top" charoff="50">0.39–0.90</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT duration of use at baseline</bold><xref ref-type="fn" rid="t3-fn12">k,</xref><xref ref-type="fn" rid="t3-fn14">m,</xref><xref ref-type="fn" rid="t3-fn15">n</xref><bold>, years</bold><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50"><5</td><td align="char" valign="top" char="." charoff="50">78</td><td align="center" valign="top" charoff="50">43 (55.1)</td><td align="char" valign="top" char="." charoff="50">0.81</td><td align="center" valign="top" charoff="50">0.54–1.22</td><td align="char" valign="top" char="." charoff="50">0.79</td><td align="center" valign="top" charoff="50">0.51–1.21</td></tr><tr><td align="left" valign="top" charoff="50">⩾5</td><td align="char" valign="top" char="." charoff="50">52</td><td align="center" valign="top" charoff="50">29 (55.8)</td><td align="char" valign="top" char="." charoff="50">0.64</td><td align="center" valign="top" charoff="50">0.41–1.00</td><td align="char" valign="top" char="." charoff="50">0.55</td><td align="center" valign="top" charoff="50">0.35–0.87</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.07</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.01</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>MHT formulation at baseline (current users only)</bold><xref ref-type="fn" rid="t3-fn12">k,</xref><xref ref-type="fn" rid="t3-fn14">m,</xref><xref ref-type="fn" rid="t3-fn16">o</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">E only</td><td align="char" valign="top" char="." charoff="50">21</td><td align="center" valign="top" charoff="50">16 (76.2)</td><td align="char" valign="top" char="." charoff="50">0.74</td><td align="center" valign="top" charoff="50">0.41–1.32</td><td align="char" valign="top" char="." charoff="50">0.64</td><td align="center" valign="top" charoff="50">0.34–1.18</td></tr><tr><td align="left" valign="top" charoff="50">E+P</td><td align="char" valign="top" char="." charoff="50">65</td><td align="center" valign="top" charoff="50">32 (49.2)</td><td align="char" valign="top" char="." charoff="50">0.63</td><td align="center" valign="top" charoff="50">0.39–1.01</td><td align="char" valign="top" char="." charoff="50">0.61</td><td align="center" valign="top" charoff="50">0.36–1.02</td></tr><tr><td align="left" valign="top" charoff="50">Other</td><td align="char" valign="top" char="." charoff="50">7</td><td align="center" valign="top" charoff="50">3 (42.9)</td><td align="char" valign="top" char="." charoff="50">0.35</td><td align="center" valign="top" charoff="50">0.08–1.53</td><td align="char" valign="top" char="." charoff="50">0.35</td><td align="center" valign="top" charoff="50">0.08–1.50</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Hysterectomy</bold><xref ref-type="fn" rid="t3-fn17">p</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">No</td><td align="char" valign="top" char="." charoff="50">452</td><td align="center" valign="top" charoff="50">231 (51.1)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">Yes</td><td align="char" valign="top" char="." charoff="50">58</td><td align="center" valign="top" charoff="50">31 (53.4)</td><td align="char" valign="top" char="." charoff="50">0.82</td><td align="center" valign="top" charoff="50">0.55–1.23</td><td align="char" valign="top" char="." charoff="50">0.80</td><td align="center" valign="top" charoff="50">0.53–1.21</td></tr><tr><td colspan="7" align="left" valign="top" charoff="50"><bold>Total ovulatory years</bold><xref ref-type="fn" rid="t3-fn18">q</xref><hr></hr></td></tr><tr><td align="left" valign="top" charoff="50">⩽27.5</td><td align="char" valign="top" char="." charoff="50">119</td><td align="center" valign="top" charoff="50">57 (47.9)</td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">Ref.</td><td align="center" valign="top" charoff="50"> </td></tr><tr><td align="left" valign="top" charoff="50">>27.5–⩽33.0</td><td align="char" valign="top" char="." charoff="50">117</td><td align="center" valign="top" charoff="50">65 (55.6)</td><td align="char" valign="top" char="." charoff="50">1.34</td><td align="center" valign="top" charoff="50">0.90–1.98</td><td align="char" valign="top" char="." charoff="50">1.33</td><td align="center" valign="top" charoff="50">0.87–2.04</td></tr><tr><td align="left" valign="top" charoff="50">>33.0–⩽36.5</td><td align="char" valign="top" char="." charoff="50">124</td><td align="center" valign="top" charoff="50">55 (47.4)</td><td align="char" valign="top" char="." charoff="50">0.75</td><td align="center" valign="top" charoff="50">0.49–1.13</td><td align="char" valign="top" char="." charoff="50">0.73</td><td align="center" valign="top" charoff="50">0.47–1.13</td></tr><tr><td align="left" valign="top" charoff="50">>36.5</td><td align="char" valign="top" char="." charoff="50">101</td><td align="center" valign="top" charoff="50">61 (60.4)</td><td align="char" valign="top" char="." charoff="50">1.22</td><td align="center" valign="top" charoff="50">0.80–1.84</td><td align="char" valign="top" char="." charoff="50">1.22</td><td align="center" valign="top" charoff="50">0.79–1.88</td></tr><tr><td align="left" valign="top" charoff="50"><italic>P</italic><sub><italic>trend</italic></sub></td><td align="left" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.74</td><td align="center" valign="top" charoff="50"> </td><td align="center" valign="top" charoff="50">0.72</td></tr></tbody></table><table-wrap-foot><fn id="t3-fn1"><p>Abbreviations: CI=confidence interval; EOC=epithelial ovarian cancer; FTP=full term pregnancy; HR=hazard ratio, MHT=menopausal hormone therapy; OC=oral contraceptive.</p></fn><fn id="t3-fn2"><label>a</label><p>Total number of serous cases <italic>n</italic>=568.</p></fn><fn id="t3-fn3"><label>b</label><p>Total number of fatal serous cases <italic>n</italic>=298.</p></fn><fn id="t3-fn4"><label>c</label><p>Adjusted for age at diagnosis (continuous) and stratified by study centre.</p></fn><fn id="t3-fn5"><label>d</label><p>Adjusted for age at diagnosis (continuous), year of diagnosis (continuous), BMI (<23 kg m<sup>−2</sup>, ⩾23–<25 (reference), ⩾25 –<30, ⩾30), tumour stage (local (reference), regional, metastatic and unknown), smoking status (never (reference), former, current and unknown) and stratified by study centre.</p></fn><fn id="t3-fn6"><label>e</label><p>Missing for ⩽2.1% of the cohort.</p></fn><fn id="t3-fn7"><label>f</label><p>Among parous women only.</p></fn><fn id="t3-fn8"><label>g</label><p>Breastfeeding was missing for 6.1% of the cohort.</p></fn><fn id="t3-fn9"><label>h</label><p>Among parous women who had ever breastfed.</p></fn><fn id="t3-fn10"><label>i</label><p>Among OC users only.</p></fn><fn id="t3-fn11"><label>j</label><p>Duration of OC use was missing for 8.3% of women.</p></fn><fn id="t3-fn12"><label>k</label><p>Among postmenopausal women only.</p></fn><fn id="t3-fn13"><label>l</label><p>Age at menopause was missing for 18.5% of postmenopausal women.</p></fn><fn id="t3-fn14"><label>m</label><p>Participants from Greece and Sweden were excluded from this analysis as detailed data on MHT use were unavailable.</p></fn><fn id="t3-fn15"><label>n</label><p>MHT duration was missing for 9.7% of individuals who ever used MHT.</p></fn><fn id="t3-fn16"><label>o</label><p>MHT formulation was missing for 7.9% of individuals who reported current use.</p></fn><fn id="t3-fn17"><label>p</label><p>Hysterectomy was missing for 10.2% of the cohort.</p></fn><fn id="t3-fn18"><label>q</label><p>Total ovulatory years was 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