Older age and family history have strong positive associations with risk of ovarian cancer, while oral contraceptive use, increased parity, breastfeeding, and tubal ligation are inversely associated with risk. Ovarian tumors are histologically heterogeneous, resembling different epithelial surfaces of the reproductive tract. Different histologic subtypes of epithelial ovarian cancer may thus have different etiologies. The inability of many studies to stratify tumors by subtype due to insufficient numbers of cases of the less common subtypes may explain the lack of consistent findings for some risk factors among studies. There is contradictory evidence for a possible increase in risk with lactose consumption, saturated fat, and talc use and for a decrease in risk with vegetable intake, while smoking appears to increase risk of mucinous ovarian tumors only. It is unclear whether obesity and/or physical activity influence ovarian cancer risk.
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