This case-control study evaluated reproductive and other factors in relation to epithelial ovarian cancer (EOC) risk. Between 1993 and 1995, the authors recruited 655 EOC cases and 3,899 population controls aged 50-74 years who were born in and residents of Sweden. Data were collected through mailed questionnaires. Odds ratios were estimated by unconditional logistic regression. Parity reduced EOC risk (odds ratio = 0.61, 95% confidence interval (CI): 0.46, 0.81) for uniparous compared with nulliparous women. The risk of EOC decreased with incomplete pregnancies, early menopausal age, late age at first birth, and unilateral oophorectomy; increased with family history of ovarian cancer; and was not associated with menarcheal age, lactation, irregular menses, and menopausal symptoms. Histology-specific odds ratios of EOC for ever compared with never users of oral contraceptives were: serous, 0.56 (95% CI: 0.42, 0.74); mucinous, 1.96 (95% CI: 1.04, 3.68); endometrioid, 0.71 (95% CI: 0.49, 1.03); clear cell, 0.66 (95% CI: 0.31, 1.43); and all EOCs, 0.73 (95% CI: 0.59, 0.90). Prolonged oral contraceptive use reduced EOC risk, with persistent protection up to 25 years after the last use. Ever use of hormone replacement therapy increased EOC risk (odds ratio = 1.41, 95% CI: 1.15, 1.72). Among etiologic hypotheses, the retrograde transportation hypothesis accommodates most epidemiologic findings concerning EOC risk.

Ever users of ERT and HRTsp but not HRTcp may be at increased risk of EOC.

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The objective of this nationwide case-control study was to examine body mass index (BMI), alcohol use, coffee consumption, cigarette smoking, and leisure-time physical activity in relation to epithelial ovarian cancer (EOC) risk. Subjects were 655 newly diagnosed EOC cases and 3899 population controls, all 50-74 years of age at recruitment between 1993 and 1995. Data were collected through mailed questionnaires. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using unconditional logistic regression. Women with a BMI > or = 30 kg/m2 compared with those with a BMI < 22 kg/m2 appeared to have an elevated EOC risk (OR = 1.37, 95% CI: 1.01-1.85), particularly of mucinous (OR = 2.76, 95% CI: 1.15-6.61) and clear-cell histologies (OR = 2.68, 95% CI: 0.96-7.48). The OR for EOC among coffee users reporting > or = 6 daily cups compared with non-users was 0.68 (95% CI: 0.42-1.10). Alcohol consumption was unrelated to EOC risk. Compared to non-smokers the ORs of EOC among current smokers were 0.70 (95% CI: 0.52-0.94) for those who smoked 1-10 cigarettes/day and 0.74 (95% CI: 0.53-1.02) for heavier smokers, while former smokers were at an unaltered risk (OR = 0.83, 95% CI: 0.66-1.04). Reduced EOC risks were observed among women in the highest compared with the lowest physical activity levels both at age 18-30 years (OR = 0.67, 95% CI: 0.52-0.87) and during the last years preceding study enrollment (OR = 0.68, 95% CI: 0.53-0.87). We conclude that women may avoid an excess risk of EOC through maintaining a normal BMI and reduce their risk by participation in leisure-time physical activity. The use of coffee, alcohol, or cigarette smoking does not appear to increase the risk of EOC.

III.

Intensity of back/low back pain increased with advancing pregnancy. There was no excess risk for urinary or vaginal infections associated with water-gymnastics. Water-gymnastics during the second half of pregnancy significantly reduced the intensity of back/ low back pain. Water-gymnastics decreased the number of women on sick-leave because of back/low back pain. Water-gymnastics during pregnancy can be recommended as a method to relieve back pain and may reduce the need for sick-leave.

A mailed questionnaire was sent to 970 consecutive women who underwent a tension-free vaginal tape (TVT) procedure between 1995 and 2001 at the Department of Obstetrics and Gynecology in Falun Hospital. Seven hundred and sixty (78.4%) women responded. The outcome was compared between women older than 75 years (n=113) and younger women, and between women with a body mass index (BMI) above 35 (n=61) and those who had normal weight. Mean follow-up was 5.7 years. Thirty-six elderly women and one of the obese women were deceased at the long-term follow-up. TVT was easy to perform and was a safe procedure for women in all groups. There was a sharp decrease in cure rate of any urinary incontinence problems among women aged 75 years or more (55.7%), as compared to those who were younger (79.7%). The cure rate moderately decreased from BMI groups 19-24 to 30-34. BMI > or =35 seemed to be the best explanatory cutoff level. The overall cure rate in women of normal weight was 81.2%, as compared to 52.1% in the very obese. The cure rate for urinary incontinence with tension-free vaginal tape in women above 75 years of age and in women with a BMI above 35 was acceptable, but lower as compared to the remaining study population.