Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort.
Identifieur interne : 002958 ( PubMed/Curation ); précédent : 002957; suivant : 002959Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort.
Auteurs : Renée T. Fortner [Allemagne] ; Jennifer Ose [Allemagne] ; Melissa A. Merritt [Royaume-Uni] ; Helena Schock [Allemagne] ; Anne Tj Nneland [Danemark] ; Louise Hansen [Danemark] ; Kim Overvad [Danemark] ; Laure Dossus [France] ; Françoise Clavel-Chapelon [France] ; Laura Baglietto [Australie] ; Heiner Boeing [Allemagne] ; Antonia Trichopoulou [Grèce] ; Vassiliki Benetou [Grèce] ; Pagona Lagiou [Grèce] ; Claudia Agnoli [Italie] ; Amalia Mattiello [Italie] ; Giovanna Masala [Italie] ; Rosario Tumino [Italie] ; Carlotta Sacerdote [Italie] ; H B As Bueno-De-Mesquita [Royaume-Uni] ; N Charlotte Onland-Moret [Pays-Bas] ; Petra H. Peeters [Pays-Bas] ; Elisabete Weiderpass [Norvège] ; Inger Torhild Gram [Norvège] ; Eric J. Duell [Espagne] ; Nerea Larra Aga [Espagne] ; Eva Ardanaz [Espagne] ; María-José Sánchez [Espagne] ; M-D Chirlaque [Espagne] ; Jenny Br Ndstedt [Suède] ; Annika Idahl [Suède] ; Eva Lundin [Suède] ; Kay-Tee Khaw [Royaume-Uni] ; Nick Wareham [Royaume-Uni] ; Ruth C. Travis [Royaume-Uni] ; Sabina Rinaldi [France] ; Isabelle Romieu [France] ; Marc J. Gunter [Royaume-Uni] ; Elio Riboli [Royaume-Uni] ; Rudolf Kaaks [Allemagne]Source :
- International journal of cancer [ 1097-0215 ] ; 2015.
Descripteurs français
- KwdFr :
- Adulte, Adulte d'âge moyen, Contraceptifs oraux hormonaux (administration et posologie), Europe (épidémiologie), Facteurs de risque, Femelle, Grossesse, Humains, Naissance à terme, Sujet âgé, Tumeurs de l'ovaire (), Tumeurs de l'ovaire (anatomopathologie), Tumeurs de l'ovaire (épidémiologie), Tumeurs épithéliales épidermoïdes et glandulaires (), Tumeurs épithéliales épidermoïdes et glandulaires (anatomopathologie), Tumeurs épithéliales épidermoïdes et glandulaires (épidémiologie), Études prospectives.
- MESH :
- administration et posologie : Contraceptifs oraux hormonaux.
- anatomopathologie : Tumeurs de l'ovaire, Tumeurs épithéliales épidermoïdes et glandulaires.
- épidémiologie : Europe, Tumeurs de l'ovaire, Tumeurs épithéliales épidermoïdes et glandulaires.
- Adulte, Adulte d'âge moyen, Facteurs de risque, Femelle, Grossesse, Humains, Naissance à terme, Sujet âgé, Tumeurs de l'ovaire, Tumeurs épithéliales épidermoïdes et glandulaires, Études prospectives.
English descriptors
- KwdEn :
- Adult, Aged, Contraceptives, Oral, Hormonal (administration & dosage), Europe (epidemiology), Female, Humans, Middle Aged, Neoplasms, Glandular and Epithelial (epidemiology), Neoplasms, Glandular and Epithelial (pathology), Neoplasms, Glandular and Epithelial (prevention & control), Ovarian Neoplasms (epidemiology), Ovarian Neoplasms (pathology), Ovarian Neoplasms (prevention & control), Pregnancy, Prospective Studies, Risk Factors, Term Birth.
- MESH :
- chemical , administration & dosage : Contraceptives, Oral, Hormonal.
- geographic , epidemiology : Europe.
- epidemiology : Neoplasms, Glandular and Epithelial, Ovarian Neoplasms.
- pathology : Neoplasms, Glandular and Epithelial, Ovarian Neoplasms.
- prevention & control : Neoplasms, Glandular and Epithelial, Ovarian Neoplasms.
- Adult, Aged, Female, Humans, Middle Aged, Pregnancy, Prospective Studies, Risk Factors, Term Birth.
Abstract
Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (i.e., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone-related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone-related risk factors (follow-up: 1992-2010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (i.e., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] vs. type II [high grade serous or endometrioid]) for full-term pregnancy (phet = 0.02). Full-term pregnancy was more strongly inversely associated with type I than type II tumors (ever vs. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33-0.69]; type II, RR: 0.81 [0.61-1.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (e.g., ever full-term pregnancy: serous, RR: 0.73 [0.58-0.92]; mucinous, RR: 0.53 [0.30-0.95]; endometrioid, RR: 0.65 [0.40-1.06]; clear cell, RR: 0.34 [0.18-0.64]; phet = 0.16). These results suggest limited heterogeneity between reproductive and hormone-related risk factors and EOC subtypes.
DOI: 10.1002/ijc.29471
PubMed: 25656413
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of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Nuthetal, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Nuthetal</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:affiliation>Hellenic Health Foundation, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Hellenic Health Foundation, Athens</wicri:regionArea></affiliation></author><author><name sortKey="Benetou, Vassiliki" sort="Benetou, Vassiliki" uniqKey="Benetou V" first="Vassiliki" last="Benetou">Vassiliki Benetou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens</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:affiliation>Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Bureau of Epidemiologic Research, Academy of Athens, Athens</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:affiliation>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.</nlm:affiliation><country 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Arezzo" Hospita, Ragusa, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospita, Ragusa</wicri:regionArea></affiliation></author><author><name sortKey="Sacerdote, Carlotta" sort="Sacerdote, Carlotta" uniqKey="Sacerdote C" first="Carlotta" last="Sacerdote">Carlotta Sacerdote</name><affiliation wicri:level="1"><nlm:affiliation>Unit of Cancer Epidemiology, AO Citta' Della Salute E Della Scienza-University of Turin and Center for Cancer Prevention (CPO), Turin, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Cancer Epidemiology, AO Citta' Della Salute E Della Scienza-University of Turin and Center for Cancer Prevention (CPO), Turin</wicri:regionArea></affiliation></author><author><name sortKey="Bueno De Mesquita, H B As" sort="Bueno De Mesquita, H B As" uniqKey="Bueno De Mesquita H" first="H B As" last="Bueno-De-Mesquita">H B As Bueno-De-Mesquita</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Onland Moret, N Charlotte" sort="Onland Moret, N Charlotte" uniqKey="Onland Moret N" first="N Charlotte" last="Onland-Moret">N Charlotte Onland-Moret</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht</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:affiliation>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht</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:affiliation>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Torhild Gram, Inger" sort="Torhild Gram, Inger" uniqKey="Torhild Gram I" first="Inger" last="Torhild Gram">Inger Torhild Gram</name><affiliation wicri:level="1"><nlm:affiliation>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø</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:affiliation>Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona</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:affiliation>Basque Health Department, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Donostia-San Sebastián, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Basque Health Department, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Donostia-San Sebastián</wicri:regionArea></affiliation></author><author><name sortKey="Ardanaz, Eva" sort="Ardanaz, Eva" uniqKey="Ardanaz E" first="Eva" last="Ardanaz">Eva Ardanaz</name><affiliation wicri:level="1"><nlm:affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBER of Epidemiology and Public Health (CIBERESP), Madrid</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:affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBER of Epidemiology and Public Health (CIBERESP), Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Chirlaque, M D" sort="Chirlaque, M D" uniqKey="Chirlaque M" first="M-D" last="Chirlaque">M-D Chirlaque</name><affiliation wicri:level="1"><nlm:affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBER of Epidemiology and Public Health (CIBERESP), Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Br Ndstedt, Jenny" sort="Br Ndstedt, Jenny" uniqKey="Br Ndstedt J" first="Jenny" last="Br Ndstedt">Jenny Br Ndstedt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund</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:affiliation>Department of Clinical Sciences, Obstetrics and Gynecology, Nutritional Research Umeå University, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Sciences, Obstetrics and Gynecology, Nutritional Research Umeå University, Umeå</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:affiliation>Department of Medical Biosciences, University of Umeå, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medical Biosciences, University of Umeå, Umeå</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:affiliation>Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Gerontology Unit, University of Cambridge, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Wareham, Nick" sort="Wareham, Nick" uniqKey="Wareham N" first="Nick" last="Wareham">Nick Wareham</name><affiliation wicri:level="1"><nlm:affiliation>MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Epidemiology Unit, University of Cambridge, Cambridge</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:affiliation>Cancer Epidemiology Unit, University of Oxford, Oxford, OX30NR, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cancer Epidemiology Unit, University of Oxford, Oxford, OX30NR</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:affiliation>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon</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:affiliation>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon</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:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</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:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</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:affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2015">2015</date><idno type="RBID">pubmed:25656413</idno><idno type="pmid">25656413</idno><idno type="doi">10.1002/ijc.29471</idno><idno type="wicri:Area/PubMed/Corpus">002A28</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">002A28</idno><idno type="wicri:Area/PubMed/Curation">002958</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">002958</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort.</title><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:affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea></affiliation></author><author><name sortKey="Ose, Jennifer" sort="Ose, Jennifer" uniqKey="Ose J" first="Jennifer" last="Ose">Jennifer Ose</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</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:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Schock, Helena" sort="Schock, Helena" uniqKey="Schock H" first="Helena" last="Schock">Helena Schock</name><affiliation wicri:level="1"><nlm:affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</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:affiliation>Danish Cancer Society Research Center, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Cancer Society Research Center, Copenhagen</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:affiliation>Danish Cancer Society Research Center, Copenhagen, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Danish Cancer Society Research Center, Copenhagen</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:affiliation>Department of Public Health Aarhus University, Section for Epidemiology, Aarhus, Denmark.</nlm:affiliation><country xml:lang="fr">Danemark</country><wicri:regionArea>Department of Public Health Aarhus University, Section for Epidemiology, Aarhus</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:affiliation>U1018, Nutrition, Hormones and Women's Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>U1018, Nutrition, Hormones and Women's Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif</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:affiliation>U1018, Nutrition, Hormones and Women's Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>U1018, Nutrition, Hormones and Women's Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif</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:affiliation>Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne</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:affiliation>Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Nuthetal, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Nuthetal</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:affiliation>Hellenic Health Foundation, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Hellenic Health Foundation, Athens</wicri:regionArea></affiliation></author><author><name sortKey="Benetou, Vassiliki" sort="Benetou, Vassiliki" uniqKey="Benetou V" first="Vassiliki" last="Benetou">Vassiliki Benetou</name><affiliation wicri:level="1"><nlm:affiliation>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens</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:affiliation>Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.</nlm:affiliation><country xml:lang="fr">Grèce</country><wicri:regionArea>Bureau of Epidemiologic Research, Academy of Athens, Athens</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:affiliation>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan</wicri:regionArea></affiliation></author><author><name sortKey="Mattiello, Amalia" sort="Mattiello, Amalia" uniqKey="Mattiello A" first="Amalia" last="Mattiello">Amalia Mattiello</name><affiliation wicri:level="1"><nlm:affiliation>Dipartimento Di Medicina Clinica E Chirurgia, Federco II University, Naples, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Dipartimento Di Medicina Clinica E Chirurgia, Federco II University, Naples</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:affiliation>Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence</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:affiliation>Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospita, Ragusa, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospita, Ragusa</wicri:regionArea></affiliation></author><author><name sortKey="Sacerdote, Carlotta" sort="Sacerdote, Carlotta" uniqKey="Sacerdote C" first="Carlotta" last="Sacerdote">Carlotta Sacerdote</name><affiliation wicri:level="1"><nlm:affiliation>Unit of Cancer Epidemiology, AO Citta' Della Salute E Della Scienza-University of Turin and Center for Cancer Prevention (CPO), Turin, Italy.</nlm:affiliation><country xml:lang="fr">Italie</country><wicri:regionArea>Unit of Cancer Epidemiology, AO Citta' Della Salute E Della Scienza-University of Turin and Center for Cancer Prevention (CPO), Turin</wicri:regionArea></affiliation></author><author><name sortKey="Bueno De Mesquita, H B As" sort="Bueno De Mesquita, H B As" uniqKey="Bueno De Mesquita H" first="H B As" last="Bueno-De-Mesquita">H B As Bueno-De-Mesquita</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</wicri:regionArea></affiliation></author><author><name sortKey="Onland Moret, N Charlotte" sort="Onland Moret, N Charlotte" uniqKey="Onland Moret N" first="N Charlotte" last="Onland-Moret">N Charlotte Onland-Moret</name><affiliation wicri:level="1"><nlm:affiliation>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht</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:affiliation>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.</nlm:affiliation><country xml:lang="fr">Pays-Bas</country><wicri:regionArea>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht</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:affiliation>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø</wicri:regionArea></affiliation></author><author><name sortKey="Torhild Gram, Inger" sort="Torhild Gram, Inger" uniqKey="Torhild Gram I" first="Inger" last="Torhild Gram">Inger Torhild Gram</name><affiliation wicri:level="1"><nlm:affiliation>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.</nlm:affiliation><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø</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:affiliation>Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona</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:affiliation>Basque Health Department, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Donostia-San Sebastián, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Basque Health Department, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Donostia-San Sebastián</wicri:regionArea></affiliation></author><author><name sortKey="Ardanaz, Eva" sort="Ardanaz, Eva" uniqKey="Ardanaz E" first="Eva" last="Ardanaz">Eva Ardanaz</name><affiliation wicri:level="1"><nlm:affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBER of Epidemiology and Public Health (CIBERESP), Madrid</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:affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBER of Epidemiology and Public Health (CIBERESP), Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Chirlaque, M D" sort="Chirlaque, M D" uniqKey="Chirlaque M" first="M-D" last="Chirlaque">M-D Chirlaque</name><affiliation wicri:level="1"><nlm:affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>CIBER of Epidemiology and Public Health (CIBERESP), Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Br Ndstedt, Jenny" sort="Br Ndstedt, Jenny" uniqKey="Br Ndstedt J" first="Jenny" last="Br Ndstedt">Jenny Br Ndstedt</name><affiliation wicri:level="1"><nlm:affiliation>Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund</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:affiliation>Department of Clinical Sciences, Obstetrics and Gynecology, Nutritional Research Umeå University, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Clinical Sciences, Obstetrics and Gynecology, Nutritional Research Umeå University, Umeå</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:affiliation>Department of Medical Biosciences, University of Umeå, Umeå, Sweden.</nlm:affiliation><country xml:lang="fr">Suède</country><wicri:regionArea>Department of Medical Biosciences, University of Umeå, Umeå</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:affiliation>Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Gerontology Unit, University of Cambridge, Cambridge</wicri:regionArea></affiliation></author><author><name sortKey="Wareham, Nick" sort="Wareham, Nick" uniqKey="Wareham N" first="Nick" last="Wareham">Nick Wareham</name><affiliation wicri:level="1"><nlm:affiliation>MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>MRC Epidemiology Unit, University of Cambridge, Cambridge</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:affiliation>Cancer Epidemiology Unit, University of Oxford, Oxford, OX30NR, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Cancer Epidemiology Unit, University of Oxford, Oxford, OX30NR</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:affiliation>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon</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:affiliation>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon</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:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</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:affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</nlm:affiliation><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London</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:affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</nlm:affiliation><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg</wicri:regionArea></affiliation></author></analytic><series><title level="j">International journal of cancer</title><idno type="eISSN">1097-0215</idno><imprint><date when="2015" type="published">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term><term>Aged</term><term>Contraceptives, Oral, Hormonal (administration & dosage)</term><term>Europe (epidemiology)</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Neoplasms, Glandular and Epithelial (epidemiology)</term><term>Neoplasms, Glandular and Epithelial (pathology)</term><term>Neoplasms, Glandular and Epithelial (prevention & control)</term><term>Ovarian Neoplasms (epidemiology)</term><term>Ovarian Neoplasms (pathology)</term><term>Ovarian Neoplasms (prevention & control)</term><term>Pregnancy</term><term>Prospective Studies</term><term>Risk Factors</term><term>Term Birth</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Contraceptifs oraux hormonaux (administration et posologie)</term><term>Europe (épidémiologie)</term><term>Facteurs de risque</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Naissance à terme</term><term>Sujet âgé</term><term>Tumeurs de l'ovaire ()</term><term>Tumeurs de l'ovaire (anatomopathologie)</term><term>Tumeurs de l'ovaire (épidémiologie)</term><term>Tumeurs épithéliales épidermoïdes et glandulaires ()</term><term>Tumeurs épithéliales épidermoïdes et glandulaires (anatomopathologie)</term><term>Tumeurs épithéliales épidermoïdes et glandulaires (épidémiologie)</term><term>Études prospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="administration & dosage" xml:lang="en"><term>Contraceptives, Oral, Hormonal</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Europe</term></keywords><keywords scheme="MESH" qualifier="administration et posologie" xml:lang="fr"><term>Contraceptifs oraux hormonaux</term></keywords><keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs de l'ovaire</term><term>Tumeurs épithéliales épidermoïdes et glandulaires</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Neoplasms, Glandular and Epithelial</term><term>Ovarian Neoplasms</term></keywords><keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Neoplasms, Glandular and Epithelial</term><term>Ovarian Neoplasms</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Neoplasms, Glandular and Epithelial</term><term>Ovarian Neoplasms</term></keywords><keywords scheme="MESH" qualifier="épidémiologie" xml:lang="fr"><term>Europe</term><term>Tumeurs de l'ovaire</term><term>Tumeurs épithéliales épidermoïdes et glandulaires</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Female</term><term>Humans</term><term>Middle Aged</term><term>Pregnancy</term><term>Prospective Studies</term><term>Risk Factors</term><term>Term Birth</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte</term><term>Adulte d'âge moyen</term><term>Facteurs de risque</term><term>Femelle</term><term>Grossesse</term><term>Humains</term><term>Naissance à terme</term><term>Sujet âgé</term><term>Tumeurs de l'ovaire</term><term>Tumeurs épithéliales épidermoïdes et glandulaires</term><term>Études prospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (i.e., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone-related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone-related risk factors (follow-up: 1992-2010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (i.e., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] vs. type II [high grade serous or endometrioid]) for full-term pregnancy (phet = 0.02). Full-term pregnancy was more strongly inversely associated with type I than type II tumors (ever vs. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33-0.69]; type II, RR: 0.81 [0.61-1.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (e.g., ever full-term pregnancy: serous, RR: 0.73 [0.58-0.92]; mucinous, RR: 0.53 [0.30-0.95]; endometrioid, RR: 0.65 [0.40-1.06]; clear cell, RR: 0.34 [0.18-0.64]; phet = 0.16). These results suggest limited heterogeneity between reproductive and hormone-related risk factors and EOC subtypes.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">25656413</PMID><DateCreated><Year>2015</Year><Month>11</Month><Day>13</Day></DateCreated><DateCompleted><Year>2016</Year><Month>02</Month><Day>29</Day></DateCompleted><DateRevised><Year>2017</Year><Month>11</Month><Day>10</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1097-0215</ISSN><JournalIssue CitedMedium="Internet"><Volume>137</Volume><Issue>5</Issue><PubDate><Year>2015</Year><Month>Sep</Month><Day>01</Day></PubDate></JournalIssue><Title>International journal of cancer</Title><ISOAbbreviation>Int. J. Cancer</ISOAbbreviation></Journal><ArticleTitle>Reproductive and hormone-related risk factors for epithelial ovarian cancer by histologic pathways, invasiveness and histologic subtypes: Results from the EPIC cohort.</ArticleTitle><Pagination><MedlinePgn>1196-208</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1002/ijc.29471</ELocationID><Abstract><AbstractText>Whether risk factors for epithelial ovarian cancer (EOC) differ by subtype (i.e., dualistic pathway of carcinogenesis, histologic subtype) is not well understood; however, data to date suggest risk factor differences. We examined associations between reproductive and hormone-related risk factors for EOC by subtype in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Among 334,126 women with data on reproductive and hormone-related risk factors (follow-up: 1992-2010), 1,245 incident cases of EOC with known histology and invasiveness were identified. Data on tumor histology, grade, and invasiveness, were available from cancer registries and pathology record review. We observed significant heterogeneity by the dualistic model (i.e., type I [low grade serous or endometrioid, mucinous, clear cell, malignant Brenner] vs. type II [high grade serous or endometrioid]) for full-term pregnancy (phet = 0.02). Full-term pregnancy was more strongly inversely associated with type I than type II tumors (ever vs. never: type I: relative risk (RR) 0.47 [95% confidence interval (CI): 0.33-0.69]; type II, RR: 0.81 [0.61-1.06]). We observed no significant differences in risk in analyses by major histologic subtypes of invasive EOC (serous, mucinous, endometrioid, clear cell). None of the investigated factors were associated with borderline tumors. Established protective factors, including duration of oral contraceptive use and full term pregnancy, were consistently inversely associated with risk across histologic subtypes (e.g., ever full-term pregnancy: serous, RR: 0.73 [0.58-0.92]; mucinous, RR: 0.53 [0.30-0.95]; endometrioid, RR: 0.65 [0.40-1.06]; clear cell, RR: 0.34 [0.18-0.64]; phet = 0.16). These results suggest limited heterogeneity between reproductive and hormone-related risk factors and EOC subtypes.</AbstractText><CopyrightInformation>© 2015 UICC.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Fortner</LastName><ForeName>Renée T</ForeName><Initials>RT</Initials><AffiliationInfo><Affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ose</LastName><ForeName>Jennifer</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Merritt</LastName><ForeName>Melissa A</ForeName><Initials>MA</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schock</LastName><ForeName>Helena</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tjønneland</LastName><ForeName>Anne</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Danish Cancer Society Research Center, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Hansen</LastName><ForeName>Louise</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Danish Cancer Society Research Center, Copenhagen, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Overvad</LastName><ForeName>Kim</ForeName><Initials>K</Initials><AffiliationInfo><Affiliation>Department of Public Health Aarhus University, Section for Epidemiology, Aarhus, Denmark.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Dossus</LastName><ForeName>Laure</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>U1018, Nutrition, Hormones and Women's Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Université Paris Sud, Unité Mixte de Recherche Scientifique 1018, Villejuif, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>U1018, Nutrition, Hormones and Women's Health Team, Institut Gustave Roussy, Villejuif, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Clavel-Chapelon</LastName><ForeName>Françoise</ForeName><Initials>F</Initials><AffiliationInfo><Affiliation>U1018, Nutrition, Hormones and Women's Health Team, Inserm, Centre for Research in Epidemiology and Population Health (CESP), Villejuif, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Université Paris Sud, Unité Mixte de Recherche Scientifique 1018, Villejuif, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>U1018, Nutrition, Hormones and Women's Health Team, Institut Gustave Roussy, Villejuif, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Baglietto</LastName><ForeName>Laura</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Cancer Epidemiology Centre, Cancer Council of Victoria, Melbourne, Australia.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Boeing</LastName><ForeName>Heiner</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, German Institute of Human Nutrition (DIfE) Potsdam-Rehbrücke, Nuthetal, Germany.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Trichopoulou</LastName><ForeName>Antonia</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Hellenic Health Foundation, Athens, Greece.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Benetou</LastName><ForeName>Vassiliki</ForeName><Initials>V</Initials><AffiliationInfo><Affiliation>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lagiou</LastName><ForeName>Pagona</ForeName><Initials>P</Initials><AffiliationInfo><Affiliation>Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Epidemiology, Harvard School of Public Health, Boston, MA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Agnoli</LastName><ForeName>Claudia</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mattiello</LastName><ForeName>Amalia</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Dipartimento Di Medicina Clinica E Chirurgia, Federco II University, Naples, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Masala</LastName><ForeName>Giovanna</ForeName><Initials>G</Initials><AffiliationInfo><Affiliation>Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-ISPO, Florence, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Tumino</LastName><ForeName>Rosario</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Cancer Registry and Histopathology Unit, "Civic-M.P. Arezzo" Hospita, Ragusa, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sacerdote</LastName><ForeName>Carlotta</ForeName><Initials>C</Initials><AffiliationInfo><Affiliation>Unit of Cancer Epidemiology, AO Citta' Della Salute E Della Scienza-University of Turin and Center for Cancer Prevention (CPO), Turin, Italy.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bueno-de-Mesquita</LastName><ForeName>H B As</ForeName><Initials>HB</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Gastroenterology and Hepatology, University Medical Centre, Utrecht, The Netherlands.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Onland-Moret</LastName><ForeName>N Charlotte</ForeName><Initials>NC</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Peeters</LastName><ForeName>Petra H</ForeName><Initials>PH</Initials><AffiliationInfo><Affiliation>Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Epidemiology, University Medical Center Utrecht, Utrecht, The Netherlands.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Weiderpass</LastName><ForeName>Elisabete</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Cancer Registry of Norway, Oslo, Norway.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Genetic Epidemiology, Folkhälsan Research Center, Helsinki, Finland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Torhild Gram</LastName><ForeName>Inger</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, the Arctic University of Norway, Tromsø, Norway.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Duell</LastName><ForeName>Eric J</ForeName><Initials>EJ</Initials><AffiliationInfo><Affiliation>Unit of Nutrition and Cancer, Catalan Institute of Oncology (ICO-IDIBELL), Barcelona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Larrañaga</LastName><ForeName>Nerea</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Basque Health Department, Public Health Division of Gipuzkoa, BIODonostia Research Institute, Donostia-San Sebastián, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Ardanaz</LastName><ForeName>Eva</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Epidemiology Unit, Navarre Public Health Institute, Pamplona, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Sánchez</LastName><ForeName>María-José</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Escuela Andaluza De Salud Pública, Instituto De Investigación Biosanitaria Ibs.GRANADA. Hospitales Universitarios De Granada/Universidad De Granada, Granada, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chirlaque</LastName><ForeName>M-D</ForeName><Initials>MD</Initials><AffiliationInfo><Affiliation>CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Epidemiology, Murcia Regional Health Authority, Murcia, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brändstedt</LastName><ForeName>Jenny</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Skåne University Hospital, Lund, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Surgery, Skåne University Hospital, Malmö, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Idahl</LastName><ForeName>Annika</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Clinical Sciences, Obstetrics and Gynecology, Nutritional Research Umeå University, Umeå, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Public Health and Clinical Medicine, Nutritional Research Umeå University, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lundin</LastName><ForeName>Eva</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Medical Biosciences, University of Umeå, Umeå, Sweden.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Public Health and Clinical Medicine, University of Umeå, Umeå, Sweden.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Khaw</LastName><ForeName>Kay-Tee</ForeName><Initials>KT</Initials><AffiliationInfo><Affiliation>Clinical Gerontology Unit, University of Cambridge, Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Wareham</LastName><ForeName>Nick</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Travis</LastName><ForeName>Ruth C</ForeName><Initials>RC</Initials><AffiliationInfo><Affiliation>Cancer Epidemiology Unit, University of Oxford, Oxford, OX30NR, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rinaldi</LastName><ForeName>Sabina</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Romieu</LastName><ForeName>Isabelle</ForeName><Initials>I</Initials><AffiliationInfo><Affiliation>Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gunter</LastName><ForeName>Marc J</ForeName><Initials>MJ</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Riboli</LastName><ForeName>Elio</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kaaks</LastName><ForeName>Rudolf</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><GrantList CompleteYN="Y"><Grant><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>G1000143</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>MC_UU_12015/1</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>MC_U106179471</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>14136</GrantID><Agency>Cancer Research UK</Agency><Country>United Kingdom</Country></Grant><Grant><Agency>Cancer Research UK</Agency><Country>United Kingdom</Country></Grant><Grant><GrantID>G0401527</GrantID><Agency>Medical Research Council</Agency><Country>United Kingdom</Country></Grant></GrantList><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D016448">Multicenter Study</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2015</Year><Month>02</Month><Day>26</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>Int J Cancer</MedlineTA><NlmUniqueID>0042124</NlmUniqueID><ISSNLinking>0020-7136</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D003278">Contraceptives, Oral, Hormonal</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C538090">Ovarian epithelial cancer</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003278" MajorTopicYN="N">Contraceptives, Oral, Hormonal</DescriptorName><QualifierName UI="Q000008" MajorTopicYN="Y">administration & dosage</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005060" MajorTopicYN="N" Type="Geographic">Europe</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009375" MajorTopicYN="N">Neoplasms, Glandular and Epithelial</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010051" MajorTopicYN="N">Ovarian Neoplasms</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName><QualifierName UI="Q000473" MajorTopicYN="Y">pathology</QualifierName><QualifierName UI="Q000517" MajorTopicYN="Y">prevention & control</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011247" MajorTopicYN="N">Pregnancy</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012307" MajorTopicYN="N">Risk Factors</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D047929" MajorTopicYN="N">Term Birth</DescriptorName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">dualistic model</Keyword><Keyword MajorTopicYN="N">histologic subtype</Keyword><Keyword MajorTopicYN="N">ovarian cancer</Keyword><Keyword MajorTopicYN="N">reproductive factors</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2014</Year><Month>12</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2015</Year><Month>01</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2015</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2015</Year><Month>2</Month><Day>7</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2016</Year><Month>3</Month><Day>2</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">25656413</ArticleId><ArticleId IdType="doi">10.1002/ijc.29471</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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