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Research Article

Genital Powder Use and Risk of Ovarian Cancer: A Pooled Analysis of 8,525 Cases and 9,859 Controls

Kathryn L. Terry, Stalo Karageorgi, Yurii B. Shvetsov, Melissa A. Merritt, Galina Lurie, Pamela J. Thompson, Michael E. Carney, Rachel Palmieri Weber, Lucy Akushevich, Wei-Hsuan Lo-Ciganic, Kara Cushing-Haugen, Weiva Sieh, Kirsten Moysich, Jennifer A. Doherty, Christina M. Nagle, Andrew Berchuck, Celeste L. Pearce, Malcolm Pike, Roberta B. Ness, Penelope M. Webb, for the Australian Cancer Study (Ovarian Cancer), and the Australian Ovarian Cancer Study Group;, Mary Anne Rossing, Joellen Schildkraut, Harvey Risch and Marc T. Goodman; on behalf of the Ovarian Cancer Association Consortium
Kathryn L. Terry
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Stalo Karageorgi
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Yurii B. Shvetsov
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Melissa A. Merritt
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Galina Lurie
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Pamela J. Thompson
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Michael E. Carney
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Rachel Palmieri Weber
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Lucy Akushevich
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Wei-Hsuan Lo-Ciganic
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Kara Cushing-Haugen
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Weiva Sieh
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Kirsten Moysich
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Jennifer A. Doherty
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Christina M. Nagle
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Andrew Berchuck
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Celeste L. Pearce
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Malcolm Pike
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Roberta B. Ness
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Penelope M. Webb
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
Mary Anne Rossing
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Joellen Schildkraut
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Harvey Risch
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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Marc T. Goodman
1Obstetrics and Gynecology Epidemiology Center, 2Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; 3Department of Obstetrics, Gynecology and Reproductive Biology, Harvard Medical School; 4Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts; 5Cancer Center, University of Hawaii, Honolulu, Hawaii; 6Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center; 7Department of Preventive Medicine, Keck School of Medicine, University of Southern California Norris Comprehensive Cancer Center, Los Angeles; 8Department of Health Research and Policy, Stanford University, Stanford, California; Departments of 9Community and Family Medicine and 10Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina; 11Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; 12Program in Epidemiology, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington; 13Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo; 14Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York; 15Department of Community and Family Medicine, Section of Biostatistics & Epidemiology, The Geisel School of Medicine at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire; 16Gynaecological Cancers Group, Queensland Institute of Medical Research, Brisbane, Queensland, Australia; 17University of Texas School of Public Health, Houston, Texas; and 18Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, Connecticut
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DOI: 10.1158/1940-6207.CAPR-13-0037 Published August 2013
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  • Figure 1.
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    Figure 1.

    Association between genital powder use and ovarian cancer risk in eight studies, Pheterogeneity = 0.61. Adjusted for age (continuous), oral contraceptive duration (never use, <2, 2–<5, 5–<10, or ≥10 years), parity (0, 1, 2, 3, or 4+ children), tubal ligation history, BMI (quartiles), race/ethnicity (non-Hispanic White, Hispanic White, Black, Asian, or other) and non-genital powder use. Studies listed in decreasing order of effect size SE (funnel plot). No evidence of heterogeneity based on Conchran's Q statistic (P = 0.61).

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    Figure 2.

    Association between genital powder use and subgroups of ovarian cancer defined by behavior and histology (A. Borderline, B. Invasive, C. Invasive serous, D. Invasive endometrioid, E. Invasive clear cell, F. mucinous.). Estimates are adjusted for the same covariates as in the model presented in Fig. 1.

Tables

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  • Table 1.

    Characteristics of eight studies included in the analysis of genital powder use and ovarian cancer

    HistologybBehaviorc
    StudyaDiagnosis yearsControlsCasesSerousMucinousEndometrioidClear cellInvasiveBorderlineQuestion used to define genital powder use
    AUSg2002–20061,4491,432889 (62%)174 (12%)132 (9%)78 (5%)1,158 (81%)274 (19%)Have you ever used any sort of powder or talc on your genital area, in your underwear or on a sanitary pad or diaphragm?
    DOVg2002–20091,8411,565905 (58%)186 (12%)201 (13%)87 (6%)1,153 (74%)412 (26%)Before (reference date) did you ever use any of the following products routinely during 1 month or more? Powder on sanitary napkins or pads? Vaginal deodorant spray? Before (reference date) did you usually apply any powder to your genital (perineal) area after bathing? We are only interested in times when you did this for at least 1 year or longer.d
    HAW1993–2008755481222 (46%)87 (18%)69 (14%)47 (10%)392 (82%)89 (19%)Before (month/year of diagnosise) did you ever use talc, baby, or deodorizing powder dusted or sprayed on your body? By regularly I mean at least once a month for 6 months or more. Did you ever use talc, baby, or deodorizing powder as a dusting powder to the genital or rectal area? As a dusting powder to sanitary napkins? As a dusting powder to underwear? On a diaphragm or cervical cap?
    HOP2003–20081,489735433 (59%)53 (7%)75 (10%)47 (6%)568 (88%)80 (12%)As an adult and before (reference month/year) did you ever use talc or baby powder or deodorizing powder with talc at least once a month for 6 months or more in any of the following ways: as a dusting powder or deodorizing spray to your genital or rectal areas? On your sanitary napkin? On your underwear? On your diaphragm or cervical cap?
    NCOg1999–2008650786489 (62%)71 (9%)100 (13%)65 (8%)636 (81%)148 (19%)Did you ever regularly use cornstarch, talc, baby, or deodorizing powders (dusted or sprayed) at least 1 time per month for at least 6 months? If yes, please tell me if you used cornstarch, talc, baby, or deodorizing powders in any of the following ways: directly to your genital or rectal areas? Applied to your sanitary napkins or tampons? Applied to birth control devices such as cervical cap or diaphragm? Applied to your underwear?
    NECg1992–20082,3292,3051,234 (54%)281 (12%)352 (15%)276 (12%)1,659 (77%)486 (23%)Did you ever regularly use powder on your body or your underwear (at least once per month for any amount of time)? If yes, did you apply powder directly to your genital or rectal areas? To your sanitary napkins or tampons? To your underwear?f
    SONg1989–1992564449254 (57%)80 (18%)71 (16%)29 (6%)365 (81%)84 (19%)Have you ever used sanitary napkins/tampons? If yes, could you tell me over what ages you have used them, for how many years, what percentage of periods you have used them for, the usual number you have used for each period, whether they were deodorant pads/tampons, and if you used talcum powder or starch on them? Have you ever regularly used talcum powder or starch on your vaginal area after showering or bathing?
    USC1993–1997782772396 (52%)131 (17%)75 (10%)32 (4%)549 (73%)205 (27%)Before (reference month/year), did you ever regularly use talc, baby, or deodorizing powder dusted or sprayed on your body? By regularly I mean at least once a month for 6 months or more. Did you ever use talc, baby, or deodorizing powder as a dusting powder to the genital or rectal area? As a dusting powder to sanitary napkins? As a dusting powder to underwear? On a diaphragm or cervical cap?
    • ↵aAUS, Australian Cancer Study; DOV, Diseases of the Ovary and their Evaluation Study; HAW, Hawaii Ovarian Cancer Study; HOP, Hormones and Ovarian Cancer Prediction Study; NCO, North Carolina Ovarian Cancer Study; NEC, New England Case Control Study; SON, Southern Ontario Ovarian Cancer Study; and USC, University of Southern California Study of Lifestyle and Women's Health.

    • ↵bCases listed by histology do not sum because mixed, other, undifferentiated, and unknown are not included.

    • ↵cCases listed by behavior do not sum to the total number of cases because 267 cases are missing behavior information.

    • ↵dIn a separate series of questions, participants were asked about powder use with diaphragm storage. Duration was calculated from ages of use. Information on duration, frequency, and timing of use was only collected on genital/perinal powder use after bathing.

    • ↵eControls were asked “Have you ever regularly used…”

    • ↵fNEC question varied slightly between the three study phases. Between 1992 and 1997 participants were asked, “As an adult and before (reference month/year), did you regularly use talc, baby, or deodorizing powders dusted or sprayed to your body in any of the following ways:”. Between 1998 and 2003, women were asked “Did you regularly apply cornstartch, talc, baby, or deodorizing body powder at least one time per month for 6 months or longer? If yes, please tell me if you regularly applied cornstarch, talc, baby or deodorizing body powders in any of the following ways:” Between 2003 and 2008 participants were asked the question listed above.

    • ↵gThese studies previously published on genital powder use and ovarian cancer risk. AUS, DOV, and NEC provided new data to the pooled analyses presented here that were not included in previous publications.

  • Table 2.

    Characteristics of cases and controls included in the pooled analysisa

    Controls (N = 9,859)Cases (N = 8,525)
    Mean (STD) or N (%)Mean (STD) or N (%)
    Age55 (12)55 (12)
    Oral contraceptive use
     Never2,995 (30)3,411 (40)
     Ever6,864 (70)5,114 (60)
    Parous
     No1,468 (15)2,196 (26)
     Yes8,391 (85)6,329 (74)
    Tubal ligation
     No7,359 (75)6,994 (82)
     Yes2,500 (25)1,531 (18)
    BMI26.5 (6.1)27.0 (6.6)
    Race/ethnicity
     Non-Hispanic White8,629 (88)7,433 (87)
     Hispanic White197 (2)214 (3)
     Black273 (3)268 (3)
     Asian350 (4)313 (4)
     Otherb407 (4)291 (4)
    Powder usec
     Never use5,815 (59)4,643 (54)
     Non-genital use only1,533 (16)1,282 (15)
     Genital use2,511 (25)2,600 (31)
    • ↵aAll characteristics listed except age differed significantly (<0.01) between cases and controls. Cases include both borderline and invasive ovarian cancers.

    • ↵bThere are 6 cases and 3 controls missing race/ethnicity information.

    • ↵cCategories for non-genital and genital powder use are mutually exclusive.

  • Table 3.

    Association between powder use and risk of ovarian cancer (borderline and invasive combined) by study site

    SiteControls (%) (N = 9,859)Cases (%) (N = 8,525)Age-adjusted OR (95% CI)aMultivariate OR (95% CI)a
    AUS
     No powder use305 (21)300 (21)1.001.00
     Non-genital use only486 (34)427 (30)0.85 (0.69–1.05)0.92 (0.74–1.14)
     Genital use658 (45)705 (49)1.04 (0.85–1.26)1.13 (0.92–1.38)
    DOVb
     No powder use1,544 (83)1,293 (83)1.001.00
     Genital use297 (16)272 (17)1.14 (0.95–1.37)1.13 (0.93–1.36)
    HAW
     No powder use489 (65)326 (68)1.001.00
     Non-genital use only154 (20)81 (17)0.79 (0.58–1.07)0.69 (0.50–0.96)
     Genital use112 (15)74 (15)0.99 (0.72–1.37)0.99 (0.70–1.41)
    HOP
     No powder use989 (66)439 (60)1.001.00
     Non-genital use only184 (13)102 (14)1.23 (0.94–1.61)1.23 (0.93–1.62)
     Genital use316 (21)194 (26)1.37 (1.11–1.69)1.34 (1.07–1.67)
    NCO
     No powder use391 (60)469 (60)1.001.00
     Non-genital use only137 (21)122 (16)0.75 (0.57–0.99)0.74 (0.56–0.99)
     Genital use122 (19)195 (25)1.33 (1.03–1.74)1.37 (1.05–1.80)
    NEC
     No powder use1,239 (53)1,129 (49)1.001.00
     Non-genital use only454 (19)421 (18)1.02 (0.87–1.19)1.04 (0.88–1.22)
     Genital use636 (27)755 (33)1.30 (1.14–1.49)1.28 (1.12–1.47)
    SONb
     No powder use364 (65)252 (56)1.001.00
     Genital use200 (35)197 (44)1.43 (1.11–1.85)1.35 (1.03–1.76)
    USC
     No powder use494 (63)435 (56)1.001.00
     Non-genital use only118 (15)129 (17)1.25 (0.94–1.66)1.14 (0.85–1.52)
     Genital use170 (22)208 (27)1.39 (1.10–1.77)1.36 (1.06–1.74)
    Pooledc
     No powder use5,815 (59)4,643 (54)1.001.00
     Non-genital use only1,533 (16)1,282 (15)0.98 (0.90–1.07)0.98 (0.89–1.07)
     Genital use2,511 (25)2,600 (31)1.25 (1.16–1.34)1.24 (1.15–1.33)
    • ↵aStudy-specific estimates were determined using unconditional logistic regression and pooled ORs were estimated using conditional logistic regression conditioned on 5-year age groups and study. Multivariate models are adjusted for age (continuous), oral contraceptive duration (never use, <2, 2–<5, 5–<10, or ≥10 years), parity (0, 1, 2, 3, or 4+ children), tubal ligation history (no or yes), BMI (quartiles), race/ethnicity (non-Hispanic White, Hispanic White, Black, Asian, or other).

    • ↵bInformation on non-genital powder use was not collected in the SON and DOV study.

    • ↵cP value for heterogeneity between multivariate study specific ORs equal to 0.61; calculated using Conchran's Q statistic test.

  • Table 4.

    Association between powder use and risk of ovarian cancer by behavior and histology

    Model 1aModel 2a
    No powder useGenital powder useNo genital powder useGenital powder use
    n (%)n (%)OR (95% CI)bn (%)n (%)OR (95% CI)b
    Controls5,815 (59)2,511 (25)7,348 (75)2,511 (25)
     All borderline cases1,035 (58)504 (28)1.29 (1.14–1.48)1,247 (72)504 (28)1.30 (1.15–1.47)
     Serous567 (57)300 (30)1.46 (1.24–1.72)700 (70)300 (30)1.45 (1.24–1.69)
     Mucinous409 (60)184 (27)1.17 (0.96–1.42)502 (73)184 (27)1.19 (0.98–1.43)
    All invasive cases3,470 (54)2,009 (31)1.21 (1.12–1.32)4,471 (69)2,009 (31)1.23 (1.14–1.32)
     Serous1,952 (53)1,197 (32)1.20 (1.09–1.32)2,519 (68)1,197 (32)1.24 (1.13–1.35)
     Mucinous206 (57)94 (26)1.09 (0.84–1.42)269 (74)94 (26)1.06 (0.82–1.36)
     Endometrioid568 (55)304 (30)1.22 (1.04–1.43)723 (70)304 (30)1.20 (1.03–1.40)
     Clear Cell327 (54)187 (31)1.24 (1.01–1.52)420 (69)187 (31)1.26 (1.04–1.52)
    • ↵aIn model 1, the reference group is restricted to women with no powder use except for the DOV and SON studies as these did not collect data on non-genital powder use. The number of cases who reported non-genital powder use was 212 (13%) of all borderline cases, 133 (13%) serous borderline, 93 (14%) mucinous borderline, 1,001 (15%) of all invasive, 567 (15%) serous invasive, 63 (17%) mucinous invasive, 155 (15%) endometrioid invasive, 93 (15%) clear cell invasive. In model 2, the reference group includes all women who did not use genital powders (nonusers and non-genital users combined).

    • ↵bORs were estimated using conditional logistic regression conditioned on 5-year age groups and adjusted for age (continuous), oral contraceptive duration (never use, <2, 2–<5, 5–<10, or ≥10 years), parity (0, 1, 2, 3, or 4+ children), tubal ligation history (no or yes), BMI (quartiles), race/ethnicity (non-Hispanic White, Hispanic White, Black, Asian, or other).

  • Table 5.

    Association between estimated lifetime applications of genital powder and risk of ovarian cancer (borderline and invasive combined)

    Lifetime number of applicationsaAll cases (N = 7,587)Nonmucinous cases (N = 6,361)
    Controls (%)Cases (%)ORb (95% CI)Cases (%)ORb (95% CI)
    Never users6,175 (76)5,384 (71)1.004,472 (70)1.00
    Quartile 1509 (6)534 (7)1.14 (1.00–1.31)467 (7)1.18 (1.02–1.36)
    Quartile 2512 (6)541 (7)1.23 (1.08–1.41)456 (7)1.22 (1.06–1.41)
    Quartile 3497 (6)542 (7)1.22 (1.07–1.40)457 (7)1.22 (1.06–1.40)
    Quartile 4486 (6)586 (8)1.32 (1.16–1.52)509 (8)1.37 (1.19–1.58)
    Ptrendc0.170.17
    • ↵aAge-specific 25th, 50th, and 75th percentile cutoff points are 612, 1,872, and 5,400 for participants < 40 years old; 612, 2,160, and 7,200 for 41–50 years; 720, 3,600, and 10,800 for 51–60 years; 1,440, 5,760, and 14,440 for 61–70; 840, 7,200, and 18,000 for > 70 years.

    • ↵bORs were estimated using conditional logistic regression conditioned on 5-year age groups and adjusted for age (continuous), oral contraceptive duration (never use, <2, 2–<5, 5–<10, or ≥10 years), parity (0, 1, 2, 3, or 4+ children), tubal ligation history (no or yes), BMI (quartiles), race/ethnicity (non-Hispanic White, Hispanic White, Black, Asian, or other).

    • ↵cTrend excludes never users.

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Cancer Prevention Research: 6 (8)
August 2013
Volume 6, Issue 8
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Genital Powder Use and Risk of Ovarian Cancer: A Pooled Analysis of 8,525 Cases and 9,859 Controls
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Genital Powder Use and Risk of Ovarian Cancer: A Pooled Analysis of 8,525 Cases and 9,859 Controls
Kathryn L. Terry, Stalo Karageorgi, Yurii B. Shvetsov, Melissa A. Merritt, Galina Lurie, Pamela J. Thompson, Michael E. Carney, Rachel Palmieri Weber, Lucy Akushevich, Wei-Hsuan Lo-Ciganic, Kara Cushing-Haugen, Weiva Sieh, Kirsten Moysich, Jennifer A. Doherty, Christina M. Nagle, Andrew Berchuck, Celeste L. Pearce, Malcolm Pike, Roberta B. Ness, Penelope M. Webb, for the Australian Cancer Study (Ovarian Cancer), and the Australian Ovarian Cancer Study Group;, Mary Anne Rossing, Joellen Schildkraut, Harvey Risch and Marc T. Goodman on behalf of the Ovarian Cancer Association Consortium
Cancer Prev Res August 1 2013 (6) (8) 811-821; DOI: 10.1158/1940-6207.CAPR-13-0037

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Genital Powder Use and Risk of Ovarian Cancer: A Pooled Analysis of 8,525 Cases and 9,859 Controls
Kathryn L. Terry, Stalo Karageorgi, Yurii B. Shvetsov, Melissa A. Merritt, Galina Lurie, Pamela J. Thompson, Michael E. Carney, Rachel Palmieri Weber, Lucy Akushevich, Wei-Hsuan Lo-Ciganic, Kara Cushing-Haugen, Weiva Sieh, Kirsten Moysich, Jennifer A. Doherty, Christina M. Nagle, Andrew Berchuck, Celeste L. Pearce, Malcolm Pike, Roberta B. Ness, Penelope M. Webb, for the Australian Cancer Study (Ovarian Cancer), and the Australian Ovarian Cancer Study Group;, Mary Anne Rossing, Joellen Schildkraut, Harvey Risch and Marc T. Goodman on behalf of the Ovarian Cancer Association Consortium
Cancer Prev Res August 1 2013 (6) (8) 811-821; DOI: 10.1158/1940-6207.CAPR-13-0037
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