Prolactin and Risk of Epithelial Ovarian Cancer

Background: Prolactin is synthesized in the ovaries and may play a role in ovarian cancer etiology. One prior prospective study observed a suggestive positive association between prolactin levels and risk of ovarian cancer. Methods: We conducted a pooled case-control study of 703 cases and 864 matched controls nested within five prospective cohorts. We used unconditional logistic regression to calculate adjusted odds ratios (OR) and 95% confidence intervals (CI) for the association between prolactin and ovarian cancer risk. We examined heterogeneity by menopausal status at blood collection, body mass index (BMI), age, and histotype. Results: Among women with known menopausal status, we observed a positive trend in the association between prolactin and ovarian cancer risk (P-trend = 0.045; OR, quartile 4 vs. 1 = 1.34; 95% CI = 0.97-1.85), but no significant association was observed for premenopausal or postmenopausal women individually (corresponding OR = 1.38; 95% CI = 0.74-2.58; P-trend = 0.32 and OR = 1.41; 95% CI = 0.93-2.13; Ptrend = 0.08, respectively; P-heterogeneity = 0.91). In stratified analyses, we observed a positive association between prolactin and risk for women with BMI = 25 kg/m(2), but not BMI < 25 kg/m(2) (corresponding OR = 2.68; 95% CI = 1.56-4.59; P-trend < 0.01 and OR = 0.90; 95% CI = 0.58-1.40; P-trend = 0.98, respectively; P-heterogeneity < 0.01). Associations did not vary by age, postmenopausal hormone therapy use, histotype, or time between blood draw and diagnosis. Conclusions: We found a trend between higher prolactin levels and increased ovarian cancer risk, especially among women with a BMI >= 25 kg/m(2). Impact: This work supports a previous study linking higher prolactin with ovarian carcinogenesis in a high adiposity setting. Future work is needed to understand the mechanism underlying this association.