Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)


School of Public Health

First Advisor

Xiaomei Ma


Background: Little is known on the etiology of early-onset ovarian cancer. We conducted a population-based case-control study in California to evaluate the role of birth characteristics on the development of early-onset ovarian cancer. Methods: Data from the California Linkage Study of Early-onset Cancers, a population-based case-control linkage study, was used. This study included 895 first primary ovarian cancer patients who were born in 1978 – 2013 and diagnosed at the age of 0-37 years and 44,750 controls frequency matched on year of birth. We utilized multivariable logistic regression analyses with the backward selection procedure to estimate odds ratios (OR) and 95% confidence intervals (CIs). Results: In the multivariable model, compared with non-Hispanic whites, Hispanics (OR= 1.63, 95% CI: 1.36 - 1.96), and other race/ethnicity (OR= 1.51, 95% CI: 1.23 - 1.84) had increased risk of early-onset ovarian cancer. In addition, every 500-gram increase in birth weight was associated with a 10% increase in the risk of early-onset ovarian cancer. Among non-Hispanic whites, individuals with foreign-born mothers had a 55% (95% CI: 1.06 - 2.27) elevated risk of early-onset ovarian cancer than those with United States-born mothers. Having a non-private insurance type decreased risk of early-onset ovarian cancer among those 0-14 years of age (OR = 0.60, 95% CI: 0.43 - 0.83); a similar decreased risk was also observed for teratoma (OR= 0.62, 95% CI: 0.42 - 0.90).

Conclusions: Our findings support the role of race/ethnicity and birth characteristics in the etiology of early-onset ovarian cancer. Risk factors of early-onset ovarian cancer show distinct features from those of later onset.


This is an Open Access Thesis.

Open Access

This Article is Open Access