Lifetime Number of Ovulatory Cycles and Risks of Ovarian and Endometrial Cancer Among Postmenopausal Women

Am J Epidemiol. 2016 May 1;183(9):800-14. doi: 10.1093/aje/kwv308. Epub 2016 Apr 15.


Previous studies have shown that a greater number of ovulatory cycles, cumulatively summed as lifetime number of ovulatory cycles (LOC), increases ovarian cancer risk, but there is no uniform algorithm with which to compute LOC. The association between LOC and endometrial cancer is less certain. Accordingly, we identified 14 different LOC algorithms in a literature review and calculated LOCs in the Polish Cancer Study (2001-2003). We evaluated the associations of LOC with ovarian and endometrial cancer risks using unconditional logistic regression, with and without adjustment for individual risk factors used in the LOC computations. Our analysis included 302 ovarian cancer cases with 1,356 controls and 532 endometrial cancer cases with 1,286 controls. We found a high correlation between LOC values among the combined controls (r ≥ 0.88) and identified 5 groups of similar LOC algorithms. A LOC value in the highest quartile was associated with ovarian cancer risk as computed by 2 algorithms (odds ratio (OR) = 2.22 (95% confidence interval (CI): 1.07, 4.62) and OR = 2.44 (95% CI: 1.22, 4.87)) and with endometrial cancer risk as computed by 1 algorithm (OR = 1.95, 95% CI: 1.11, 3.44). LOC algorithms using a core set of variables widely available in epidemiologic studies may be independently associated with risk of gynecological cancers beyond the contribution of the individual risk factors, such as ages at menopause and menarche.

Keywords: age at menarche; age at menopause; endometrial cancer; incessant ovulation; lifetime ovulatory cycles; ovarian cancer; ovulation.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Aged
  • Algorithms
  • Case-Control Studies
  • Endometrial Neoplasms / epidemiology*
  • Female
  • Humans
  • Logistic Models
  • Menarche / physiology
  • Middle Aged
  • Odds Ratio
  • Ovarian Neoplasms / epidemiology*
  • Ovulation / physiology*
  • Poland / epidemiology
  • Postmenopause
  • Risk Factors
  • Young Adult