Fortner RT, et al. - Whether risk factor profiles impact tumor aggressiveness (defined by time between diagnosis and death) independent of histology in ovarian cancer was investigated by analyzing 4,584 cases with invasive epithelial ovarian cancers, including highly aggressive (death in <1 year, n = 864), very aggressive (death in 1 to < 3 years, n = 1,390), moderately aggressive (death in 3 to < 5 years, n = 639), and less aggressive (lived 5+ years, n = 1,691) ones. Researchers found the links between parity, family history of ovarian cancer, body mass index (BMI) and smoking and ovarian cancer risk differed by aggressiveness. An inverse relation of a first/single pregnancy vs nulliparity to highly aggressive disease was observed; no link was observed for subsequent pregnancies. Only the risk of less aggressive disease was noted in relation to family history of ovarian cancer. Increased risk of highly aggressive disease was observed in association with high BMI and current smoking. Within histotypes, comparable results were seen. Findings suggested a direct association of ovarian cancer risk factors with subtypes defined by tumor aggressiveness rather than through differential impacts on histology.