Potential causal associations of 100 known and suspected influencing
factors with risk of overall ovarian cancer and six histotypes: A
Mendelian randomization study
Abstract
Background: Observational studies have linked various exposures
to ovarian cancer (OC) risk, but the findings are potential subject to
reverse causation and confounding. Herein, we performed comprehensive
Mendelian randomization (MR) analyses to systematicly evaluate potential
causal associations of known and suspected influencing factors with risk
of OC and six common histotypes. Methods: Two-sample MR
analyses were applied to data from the genome wide association study
summary results comprising a total of 25,509 women with epithelial OC
and 40,941 controls of European descent in the Ovarian Cancer
Association Consortium. Genetic instrumental variables associated with
influencing factors were selected. Inverse-variance weighted method was
used as the primary analysis, and the MR assumptions were evaluated in
sensitivity analyses. MR-PRESSO method was applied for the detection and
correction of potential horizontal pleiotropy. Results: OC and
six histotypes were considered in this study. Of 100 known and suspected
influencing factors, 7 lifestyle factors, 12 dietary factors, 4
reproductive factors, 12 body size factors, 3 comobidities, and 7
biomarkers were significantly associated with risk of OC. Among them,
26, 9, 25, 19, 5, 13, and 22 factors were associated with the risk of
OC, clear cell OC, endometrioid OC, high grade serous OC, low grade
serous OC, mucinous OC, and low malignant potential OC respectively.
Conclusion: Our study adds to current knowledge on the causal
effect of known and suspected influencing factors on OC and six
histotypes. Further investigation is needed to better understand
potential pathways or mechanisms of these factors.