Usset, Joseph

Abstract Background: Many epithelial ovarian cancer (EOC) risk factors relate to hormone exposure and elevated estrogen levels are associated with obesity in postmenopausal women. Therefore, we hypothesized that gene–environment interactions related to hormone-related risk factors could differ between obese and non-obese women. Methods: We considered interactions between 11,441 SNPs within 80 candidate genes related to hormone biosynthesis and metabolism and insulin-like growth factors with six hormone-related factors (oral contraceptive use, parity, endometriosis, tubal ligation, hormone replacement therapy, and estrogen use) and assessed whether these interactions differed between obese and non-obese women. Interactions were assessed using logistic regression models and data from 14 case–control studies (6,247 cases; 10,379 controls). Histotype-specific analyses were also completed. Results: SNPs in the following candidate genes showed notable interaction: IGF1R (rs41497346, estrogen plus progesterone hormone therapy, histology = all, P = 4.9 × 10−6) and ESR1 (rs12661437, endometriosis, histology = all, P = 1.5 × 10−5). The most notable obesity–gene–hormone risk factor interaction was within INSR (rs113759408, parity, histology = endometrioid, P = 8.8 × 10−6). Conclusions: We have demonstrated the feasibility of assessing multifactor interactions in large genetic epidemiology studies. Follow-up studies are necessary to assess the robustness of our findings for ESR1, CYP11A1, IGF1R, CYP11B1, INSR, and IGFBP2. Future work is needed to develop powerful statistical methods able to detect these complex interactions. Impact: Assessment of multifactor interaction is feasible, and, here, suggests that the relationship between genetic variants within candidate genes and hormone-related risk factors may vary EOC susceptibility. Cancer Epidemiol Biomarkers Prev; 25(5); 780–90. ©2016 AACR.

Abstract Background: We investigated the role of multifactor interactions and epithelial ovarian cancer (EOC) risk using data collected within the Collaborative Oncological Gene-environment Study and the Ovarian Cancer Association Consortium containing 18,000 EOC cases and 26,000 controls. To date, researchers have identified 18 EOC susceptibility loci. However, it has been estimated that many more common variant loci exist; we hypothesized that some of the unexplained variation is due to gene-environment interactions. Similar to breast and endometrial cancers, many EOC risk factors relate to estrogen exposure, and increased levels of estrogen has been associated with obesity in post-menopausal women. Therefore, we hypothesized that gene-environment interactions dealing with hormone-related risk factors could differ between obese and non-obese women. Methods: We considered multifactor interactions between single nucleotide polymorphisms (SNPs) and six hormone-related factors: oral contraceptive use; parity; endometriosis; tubal ligation; hormone replacement therapy (HRT); and estrogen use; and assessed whether these GE interactions differed between obese and non-obese women. The SNPs included in this analysis included the top associated markers within the 18 confirmed risk loci, as well as, 36,811 SNPs that lie within 84 candidate gene regions related to hormone biosynthesis & metabolism and insulin-like growth factors. For the candidate SNP analyses, we assessed multifactor interactions across environmental factors using logistic regression models including age, study site, and population substructure. For the candidate gene analyses, a two-stage screening and testing procedure was utilized. All analyses were completed including: (1) all histologies; and (2) only serous histology. Results: For the 18 known EOC risk loci, no hormone-related risk factors showed statistically significant interaction at a threshold of 10-4. In contrast, the two-stage analysis of the candidate genes found several significant gene-environment-environment effects, after adjusting for multiple testing. For analysis of all cases, the SNPs in the following candidate genes showed a multifactor interaction with a hormone-related risk factor and obesity: IGFBP5 (HRT, rs729597, p = 1.3×10-13), CGA (HRT, rs58124219, p = 1.0×10-5), and SSTR1 (parity, rs77266093, p = 1.1×10-5). Similarly, the serous histology analyses detected a multifactor interaction with HRT, obesity and IGFBP5 (rs729597, p = 8.8×10-5). Additionally, serous only analyses also detected an interaction involving ESR1 (tubal ligation, Chr6:152246911(indel), p = 8.0×10-6). Conclusions: In a very large case-control collection, assessment of multifactor gene-environment interaction is feasible, and, here, suggest that the relationship between SNPs in candidate genes and hormone-related risk factors in EOC susceptibility may vary. Citation Format: Joseph Usset, Brooke Fridley, Ellen Goode, Joellen Schildkraut, Paul Pharoah. Assessment of multifactor gene-environment interactions and ovarian cancer risk: SNPs, obesity, and hormone-related risk factors. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4684. doi:10.1158/1538-7445.AM2015-4684