eTable 1: Regular use of Acetaminophen and risk of ovarian cancer in the HOPE study
No of Cases No. of Controls OR (95% CI)a
Nonuserb 738 1,447 1.00
Regular usersc 164 355 0.98 (0.79, 1.23)
Types of usersd Continuous 98 212 0.98 (0.74, 1.30) Current 9 24 0.81 (0.36, 1.83) Past 57 119 1.02 (0.72, 1.45)
Standardized daily dosee Low 136 291 0.99 (0.77, 1.26) Moderate-High 28 64 0.98 (0.60, 1.60)
Age at first use (years) < 45 86 175 1.02 (0.75, 1.37) ≥ 45 78 180 0.95 (0.70, 1.30)
Age at last use (years) < 55 84 183 0.98 (0.72, 1.32) ≥ 55 80 172 0.99 (0.73, 1.35)
Time since first use (years) < 10 82 167 1.05 (0.78, 1.43) ≥ 10 81 188 0.91 (0.68, 1.23)
Time since last use (years) < 4 114 256 0.94 (0.72, 1.22) ≥ 4 49 99 1.08 (0.74, 1.56)
a: ORs and p-values are adjusted by age at reference year, interview year, study center, race, education, breastfeeding, numbers of full-term, duration of oral contraception use (years), body mass index, postmenopausal hormone use, arthritis, diabetes, and prior tubal ligation. b: Non-user: Women who indicated that they had not used acetaminophen (but may or may not use aspirin or NA-NSAIDs) ≥ 2 tablets/per week for at least 6 months (“minimal level”). Reference category. c: Regular user: women who indicated that they had used acetaminophen (but may or may not use aspirin or NA-NSAIDs) ≥ 2 tablets/per week for at least 6 months d: Duration of use was defined by three indicators: (1) continuous (had used for at least 1 year and until or beyond the reference date); (2) current (used only less than a year and used on the reference date); (3) past users (discontinued use at least 1 year before the reference date). e: Only 6 cases and 9 controls used high standardized daily dose of acetaminophen, so we combined moderate- and high-standardized daily dose into one group (moderate-high)
eTable 2: Regular use of NA-NSAIDs only or Acetaminophen by self-reported indications and risk of ovarian cancer in the
HOPE study
NA-NSAIDs only Acetaminophen
No. Cases No. Controls OR (95% CI)a No. Cases No. Controls OR (95% CI)a
Nonusers b 456 850 1.00 738 1447 1.00
Regular usersc by indicationsd
Arthritis/bursitis, rheumatism 74 191 0.85 (0.59, 1.21) 62 161 0.88 (0.62, 1.25)
Headache 16 38 0.99 (0.51, 1.91) 50 100 1.05 (0.72, 1.53)
Other pain or injuries 85 127 1.33 (0.96, 1.85) 65 125 1.04 (0.73, 1.46)
a: ORs and p-values were adjusted by age at reference year, interview year, region of residence, race, education, breastfeeding, numbers of full-term births, duration of oral contraception use (years), body mass index, postmenopausal hormone use, arthritis, diabetes, and prior tubal ligation. b: Non-user: for NA-NSAIDs only, women who indicated that they had not used aspirin or NA-NSAIDs ≥ 2 tablets/week for ≥ 6 months (“minimal level”); for acetaminophen, Women who indicated that they had not used acetaminophen (but may or may not use aspirin or NA-NSAIDs) ≥ 2 tablets/per week for at least 6 months. Reference category. c: Regular user: women who indicated that they had used aspirin≥ 2 tablets/week for ≥ 6 months d: If patients used NA-NSAIDs (or acetaminophen) for different major indications before the reference date, each episode (indication) was counted separately
eTable 3: Regular use of Aspirin, NA-NSAID, Acetaminophen and Risk of Ovarian Cancer by Tumor
Behaviors and Histologic Types in the HOPE study
OR (95% CI)a among Regular usersb
Aspirin only NA-NSAID only Aspirin plus NA-NSAID
Nonusers c 1.00 1.00 1.00
Tumor Behaviors
Borderline or low-malignant potential 0.66 (0.43, 1.02) 1.04 (0.60, 1.60) 0.74 (0.44, 1.24)
Invasive 0.79 (0.62, 1.02) 1.06 (0.82, 1.39) 0.99 (0.73, 1.34)
Histologic Types
Serous 0.79 (0.59, 1.05) 0.95 (0.70, 1.30) 0.75 (0.52, 1.08)
Non-Serouse 0.83 (0.58, 1.19) 1.27 (0.90, 1.78) 1.30 (0.87, 1.93)
a: The ORs were adjusted by age at reference year, interview year, region of residence, race, education, breastfeeding, numbers of full-term births , duration of oral contraception use (years), body mass index, postmenopausal hormone use, arthritis, diabetes, and prior tubal ligation. b: Regular user: women who indicated that they had used aspirin/NA-NSAIDs/aspirin plus NA-NSAIDs ≥ 2 tablets/week for ≥ 6 months c: Non-user: Women who indicated that they did not use aspirin or NA-NSAIDs ≥ 2 tablets/week for ≥ 6 months (“minimal level”). Reference category e: Non-serous types include mucinous (n=66), endometrioid (n=100), clear cell (n=54), mixed cells (n=77), and other/unknown epithelial tumors (n=89). Except serous type, other histologic types had small sample sizes, resulting in imprecise estimates.
eTable 4: Regular Use of Aspirin, NA-NSAID or Acetaminophen and Risks of Ovarian Cancer in the HOPE Study (Definition of non-users: without use any analgesics regularly)
No. of No. of OR (95% CI)a
Cases Controls
Nonuserb 411 784 1.00
Regular users 491 1018 0.97 (0.81, 1.16)
Aspirin only 136 285 0.79 (0.61, 1.04)
Types of users c
Continuous 102 234 0.73 (0.54, 0.98)
Current 5 15 0.50 (1.18, 1.44)
Past 29 36 1.43 (0.82, 2.51)
SDDd
Low 77 197 0.68 (0.49,0.94)
Moderate 41 61 0.97 (0.62, 1.53)
High 18 27 1.07 (0.54, 2.10)
NA-NSAID only 119 232 1.13 (0.86, 1.49)
Types of users c
Continuous 65 131 1.14 (0.80, 1.62)
Current 8 22 0.85 (0.35, 2.06)
Past 46 79 1.30 (0.85, 2.01)
SDDd
Low 68 120 1.25 (0.88, 1.79)
Moderate 24 58 0.96 (0.56, 1.65) High 27 54 1.19 (0.70, 2.02)
Aspirin + NA-NSAID 72 146 1.09 (0.76, 1.55)
Types of users c
Continuous 61 125 1.07 (0.74, 1.57)
Current 4 5 2.62 (0.63, 10.80)
Past 7 16 0.82 (0.31, 2.16)
Standardized daily dosed
Low 42 94 0.89 (0.58, 1.38)
Moderate 17 34 1.39 (0.72, 2.67)
High 13 18 1.70 (0.78, 3.70)
Acetaminophen onlye 45 66 1.26 (0.81, 1.95)
Aspirin plus Acetaminophene 33 75 0.92 (0.58, 1.47)
Acetaminophen plus NA-NSAIDe 48 104 0.94 (0.62, 1.44)
Aspirin plus Acetaminophen plus NA-NSAID 38 110 0.83 (0.53, 1.30)
a: The ORs were adjusted by age at reference year, interview year, region of residence, race, education, breastfeeding, numbers of full-term births,
duration of oral contraception use (years), body mass index, postmenopausal hormone use, arthritis, diabetes, and prior tubal ligation.
b: Non-user: Women who indicated that they did not used any aspirin, NA-NSAIDs or acetaminophen ≥ 2 tablets/week for ≥ 6 months
(“minimal level”). Reference category.
c: Duration of use was defined by three indicators: (1) continuous (had used for at least 1 year and until or beyond the reference date); (2) current
(used only less than a year and used on the reference date); (3) past users (discontinued use at least 1 year before the reference date).
d: To examine dose-response effects, the average daily dose was converted to a standardized daily dose by dividing it minimal effective analgesic
doses per day. Dosages were categorized into two clinically relevant categories: low-dose (≤ 0.5SDD), moderate -to-high dose (>0.5 SDD).
e: Subgroup analyses of dose- and duration-effects were not shown due to relatively small sample size in cases.
10 No.
CONTINUATION BOOK USED: 0 No 0 Yes
HOPE
(HORMONES AND OVARIAN CANCER PREDICTION)
UNIVERSITY OF PITISBURGH CANCER INSTITUTE UNIVERSITY OF PITISBURGH, GRADUATE SCHOOL OF PUBLIC HEALTH AND MAGEE-WOMENS HOSPITAL
Pis: Franoesmary Modugno, Ph.D., M.P.H. Roberta B. Ness, M.D., M.P.H.
Revision: September 10, 2003
...__._------ .~ 6904 SECTION A:BEFORE AND AFTER INTERVIEW REVlSION 911012003 •
A1. 10 Number IONU""
A2. case/Control Status \ -: 0 Case~ 0 Control c.. F\?E.c..OrJ
A3. Area Code and Telephone Prefix
A4. County _ [[] l-\G;hJ.. AS. Institutio" _ Code "99" for controls [[] \N~"TN c\:..\v...J,t- -, A6. Date of Interview OJ I OJ I [[IIJ INi'<'J DAlE. rna da yr -~J\.7. Reference MonthNear (REF MO YR*) -his is 9 months BEFORE todBy's Date. mo yr AS. Interviewer 10 [[] A9. Place of Interview \ N l" LDC. o o Home I 0 Wor!< 1. 0 Study Center ~ 0 HOBpitallClinic '\ 0 other Spe 0.:0 First (initial) Interview A10. Interview Type I:: 0 Verification (second) Interview • Page 1 of 72 • ------_.._. .~ 8904 SECTION B: DEMOGRAPHICS • First, I have some questions about your background. 81. Date of Birth 82. Age in 'REF MO YR' PTf\Eo", \'>II\TI\ In rn /rn /rnrn LU cI.~"']... mo d. B3. State or country where you were bom, ITIJ 84. What country did your mother's ancestors come from? (SHOW CARD) (If unknown. write "don't know" and leave code blank) a.c.'o..u \-\--1 1. OTI 1'110 l-tJII'.'/ \ 2. OTI lI\oc.t-.lI«.~ z.. f'/\oc.tJ,~~ 3. OJ] '!> 4. OJ] '"D (..t-lT f'.. '/ l.\ OTI 2. _ OTI 3. _ OTI 4. _ OTI B6.1. Consider yoursellto be Hispanic (P a No 1<0 Yes HI5 Pl\tJ,c. B6.2 Which race do you consider yourself? (SHOW CARD) 1'-r~A.c.e: 0-' 0 White I> 0 Black '1.'0 Asian/PI, 0 American Indian or Aleut '10 Multi (SP) So Other (SP) . - • Page 2 01 72 . ,,-',." '" , • ...... _--- .~ 6904 • B7. Highest year of school that you completed (SHOW CARD) EouC. a 0 Less than high school \ 0 Some high school 1.. 0 High school graduate or GED 3 0 Post high school training not college Lt 0 Some college 5 0 Graduated from college lP 0 Post graduate 88. In what religion were you raised? (SHOW CARD) Pi RE-LI" 0 o Roman Catholic o Protestant 1 o Jewish 3 o Moslem 't o Atheist 5 o Agnostic or None l;> o Other (SP) 89. In what religion was your biological mother raised? (SHOW CARD) o 0 Roman Catholic o Protestant 1. 0 Jewish 30 Moslem 't 0 Atheiot 5 0 Agnostic or None t.. 0 Other (SP) - 3 0 Don't know 810. In what religion was your biological father raised? (SHOW CARD) o 0 Roman Catholic o Protestant 1. 0 Jewish 3 0 Moslem "" 0 Atheist 5 0 Agnostic or None (p 0 Other (SP) -:3 0 Don't know • Page 3 of 72 • ~ SECTION C: PREGNANCY HISTORY • 7479 • \ ONU M C1. Have you ever been pregnant? o NO (Go to section OJ OYES PREG 1 PREG 2 PREG 3 PREG 4 C2.ln what month and CD ?1l£b.L,""O CD re.Eb.~MO Fi'.£<> IF LIVE OR STILLBIRTH C4. Was this a single birth or twins? T'/ e,1~\\T \ Y'I 6, I'T \' Z- "fB\£'-1\' 3 '1'01 \O.H\ 't [) o Single Birth o Single Birth o Single Birth o Smgle Birth o Identical Twins o Identical Twins o Identical Twins o Identical Twins 1- o Fraternal twins o Fraternal twins o Fraternal twins o Fraternal twins J o other (SP) o other (SP) o other (SP) o other (SP) C5. Was it a boy or girl? BD~ 6.\(2.L I BDYE,I!<.L"2.. 'CI:::tt 6, \2.L- 3 F!>::>f bI PREG 1 PREG 2 PREG 3 PREG 4 C6. Did you BICfE:ED \ Se.fEEDz. Bi:FEtOD3 I3f.F" " 0 'i breastfeed this 0::0 N gotoCB ON go to C8 ON go to CB ON go to CB baby? \~OY OY OY OY BrEED Ho I BfcC:DHuL C7. If breastfed e,fEEDHo3, l3'EED HO 't fhis baby: How many months did ITJ ITJ [IJ [IJ you nurse'? months months months months de..--\<:w \t 5~ Let's now record breast feeding on the calendar for each month that you breastfed. Put breast feeding on the calendar C8. How much W'"IGt-lPR\ Wl\\E>tJP"z.. weight did you gain with this ITJ ITJ pregnancy? pounds pounds pounds pounds dG~\'" eB PP~IJ~'1- eg. How many I'PMEtJ";.\ PftllE>b l. PfI-IErb3> r---''Is after the b .Jf this baby [IJ [IJ [IJ [IJ did it take before you got back to months months months months your pre-pregnant (k_~\t B8 menstrual pattern? V'f\~\ DI~e>L C10. Were you G. Go diagnosed with 0-= 0 N ON ges,fatlonal diabetes \ := 0 y OY with this pregnancy? C11. Were Ulere any 0:: 0 N o N Ho Pe.Eb l ON MoPlZ4.3 ON HD PU (USE CONnNUATION PAGES IF NEEDED) C12. We have recorded [IJpregnanCies and ITJlive births. dua...,lt 58 NU/Yl PfU6, rVUfYiBIRTH Interviewer prompt: Were there any other pregnancies before "REF MO YR'" that you can recall? If yes, go to C2. Page 5 of 72 • ~ • - -.-._------ ~ • 7479 SECTION D: PROBLEMS GETTING PREGNANT • Now I'd like to ask you about any problems that you may have had in getting pregnant 01. Have you or a partner ever talked to a o~ a N (GO to D6) doctor or had tests done because of problems getting pregnant? I ~ OY 02. What year did you or a partner first talk to a '1~FI'-TT~T doctor or have tests done because of problems ITIIJ getting pregnant? year 03. Who was tested? Q,. a Partner 1-0 Self Z.o Both 3'0 Neither 04. Were any of the following found to be probable causes of problems getting pregnant? (SHOW CARD) 0 \ -3 O. Your partner's sperm, such as a low sperm count ON oy ODK \.-Ow :> ~e: ItM 1. A problem with your ovaries such as cysts ON Oy ODK o ,Al<<,,/,,-r 2. A problem with ovulation, such as not releasing eggs ON oy a OK P"o"oJ U l 3. A problem with your tubes, such as blocked tubes ON oy ODK I'I2.T0e>ES 4. A problem with your cervix, such as inflammation ON oy ODK f 'l(..E. ~-J I "A 5. A problem with the way your uterus developed, such as ON oy ODK ~ bicornate or a double uterus P Il.u TE I 7. A problem with menstruation, such as heavy bleeding or ON OY o OK 1'!'.I'-\EtJ:> absence of periods B. Endometriosis ON oy ODK C.N OO!'-'\ 'E."\fi'-.. 9. Problems with cervical mucous ON OY ODK c.. E ~-.} M I,J r.-c 10. Some other problem (Specify) ON oy ODK o elSoET I'R" • Page 6 of 72 • ._- _._ ~ • 7479 • 05. Did you ever have any of these fertility treatments or - How many times? surgeries (SHOW CARD) O. Blocked tubes opened up --rVI') \0 0 i'lOt-! OON lOY ·'0 OJ( CD Tf-.\T~PEN 0 I -3 1. Artificial insemination fll'-"N>cM ON OY o DK CD lMIH<:TIN~ ~ 2. In vitro fertilization (IVF) \ l- ON OY ODK Tt-\!-J F CD Ifyes: 2.1 Were the eggs donated by another woman? ON OY ODK \ \I f Ebb", 3. A gamete intra-fallopian transfer (GIFT) G.IPT ON OY ODK CD TNc,lfT If yes: 3.1 Were the eggs donated by another woman? ON OY ODK G,! FTEbb':> 4. A zygote intra~fallopjan transfer (ZIFT) L. \fl ON OY o OK [DLIFT If yes: 4.1 Were the eggs donated by another woman? ON OY ODK 7-lf,EbbS 5. A tubal embryo transfer (TET) .,.. EO' ON OY o DK If yes; CDTHWT 5.1 Were the eggs donated by another woman? ON OY ODK .--E:T EEo&. '" 6. Other infertility surgery (sp) ON O! tJ fSU~b. oY ODK CDTKOlfSR6. ASK ALL PARTICIPANTS D6. Before "REF MO YR", did you take any fertility dnugs or 0;; 0 N (Go to section E) medications, either to donate eggs or help you get pregnant? I ;; 0 Y - o E:i.' D "-ue., • Page 7 of 72 • ------.~ 7479 IF EVER USED FERTILITY DRUGS • DRUG 1 DRUG 2 DRUG 3 DRUG 4 ---- 07. Please tell me the name otthe [first/next] fertility drug you used ern ern 0:::0 0:::0 CODE CODE CODE CODE (SHOW PHOTO) r{2.,DRuG.1 f 1'-\\)\I.\J b. 2- FI ~FF 08. In what month and rn OlW&.\ MI'FP\OLlb1.. HFfvIW",?> I'\r'FPN",\ year did you ftrstuse rn rn rn this drug?" rno rno rno rno [IT]] [IT]] [IT]] CIIIJ year'jffD12Llb I year 'j FrO iWbz.. year 'iFFDQLlt,~ year 'i FF D","u,,'t 09. In what month and year dlcl you last OJ f-ILfDl2,Ub \ use this drug?" rno [IT]] I [[] [IT]] ITIIJ year 'f Lf DI2JJ b , year 'i~fDIGLl"'L year 'iLfDlWb~ year YLfDe. (Record fertility drug use on calendar) 010. How many months did you OJ IT] actually use It? rnrno rnrno rno rno k II F DIWbo \ M Ll F DRLlb z.. NLl fJ) lOJ & ~ Hu. F 0 "'- ,"lin '1 D11.WaslttD ON ~O ON ON ON induce ovulatlon, that is, to help to OV . \ OV OV OV make more eggs? OOK=-:') OOK OOK OOK E.>.b~:' ~"'b:''-t I'-IOEc&.b~ I kD E.6b':> 7- hb HD 012. Was this medication in the o Pill =0 o Pill o Pill o Pill form or a pili or OShOI = I o Shot Shot OShot shot? o f"Rl\ '> ItO T I F i!-x..5 HOT z.. f' R.<~ tlO"'::> Fl2JC> ~ OT '+ D13.Dld you ever take any other ON=O drug or ON ON ON medications to OY -= \ OY OY OY '-"elp you get ,.lregnant? ODR0("V\z \ ODlLubflLL.- OV(u~ Pl.3 ogfu6.fl'-'"t Page 8 of 72 • ...... _- _---_._ _-",,_. • -----_ .~ SECTION E: BIRTH CONTROL 45032 • I Dr.JUfYI These next questions are about methods of family planning or birth control that you or your partner may have used E1. How many male sex partners did you (If no psrtnsrs, GO TO E3) have before 'REF MO YR' ? ITJ number N l) "'" PA R:I c).G-f-o..v.l ~ - L. E1.1 Ifever had male sex parlners: How old were you when you had sexual intercourse A&.E- flt.:>EI with a man for the very first time? ITJ c.\e-fw.,. \-\ - L age E2. This card lists the various methods used to avoid getting pregnant. Did you (or your male partner) ever use any of these methods of birth control before 'REF MO YR' (SHOW CARD) o 1. Birth control pills ON OY 2. Birth control shots or implants ON OY 3. Birth control patch or ring ON OY 4. IUDs ON OY Be-I UD 5. Diaphragm ON OY Be..0 \ "'? 'IV 6. Male Condom ON OY "" PI '-E: '-t-J " M L· 7. Female Condom ON OY ~ e:. \'J\ c...N D ~" 8. Cervical cap or ring ON OY C&jl~Cp. p. g Sponge ON OY r-,c- :;'PONEo €.v 10. Contraceptive foams, creams, jellies ON OY 11. Natural family planning or rhythm ON OY 12. Withdrawal ON QY 13. Tubal ligation ON QY 14. Vasectomy ON OY "" f\'? eel"'y 15. Other (sp) ON OY 0-';; Be-H,f\ _ E3. Did you ever take birth control pills, or use birth control shots, patches, rings, or implants for reasons other than birth control? ON OY ~DT>le.EA • Page 9 of 72 • ~ DID YOU EVER USE BIRTH CONTROL PILLS? N Y • 45032 • 1 2 3 4 E4. Record month and ~ PU_LM~\~ PILLt-\'?\1 rn V LI.-tJ,. '-:> f :L qILLJ'''ST4 ~ilr rn nrstlnext took rn rn birth control pills mo mo mo mo ITIJJ ITIJJ ITIJJ ITIJJ year !'ILL'!."T I year (', u.. '/'T z.. year PIL.L.'1>T~ year I'ILL'/,:>T4 E5. Record month and plLu--IE.N I (7ILLt-Ie.,JL P,LLME.'" 0, I'\LLMo.N'I yeaf stopped for at rn rn rn rn least 1 month, pill mo mo mo mo ITIJJ ITIJJ ITIJJ D~ D year 1'1 Ll-'jEN \ year PI LL'J<.N 2- year qILL'fE.,.l~ year (7, LL'/ Ef.l "r If stopped and started pills, work out start and end dates for each separate episode Mark OC on calendar E6. Why did you take this pili? (SHOW CARD) 0 \ C- 0 I 0 - ~ILL~U & Control ON OY ON OY PILL~2... ON o y PILLB,-> 0 N OY P\LL(y.'-I Regulate periods ON o Y PILLPO I ON o Y l"LLPD I ON o Y PILl-PIB 0 N OY 'PILL!" D "+ Control heavy periods ON o y p\LLMrl'1 ON o Y p.l..l,.l\f'O Z- ON o Y Plu...HPP30 N o y f'11.-1.-\-\-fDt Treat painful periods ON o y P,Ll-fro I ON o y QILLrp2l.>- ON o y rlLLffD~O N o y PILLP'0't Treat acne/skin ON o y I'ILLAI..N \ ON OY QIu-I'ILNl.. ON o Y 91L1J'<.lJ30 N o y P ILLf'<.N 't Treat endometriosis ON 0 Y r,LLe:"OI 0 N Oy f\LU:.~01.. ON o y PILL<:"o;O N o y 1'1Ll-€>-l0'f Treat ovarian problems ON OyPIL.LC>J1'1 0 N OY PILLOvP Z. ON o yP,LJ...Ll\iP3 0 N o y PIl.LD,W'! such as ovarian cysts OyPILLPt-\~1 Treat PMS ON ON o yQI<.J... f'M:?Z ON o Y Plu...i'h:>;lO N o y I'ILLPHs Other reasonlsp): ON OY~ILU)~'>I ON o y P,u-olZ.52. ON o yf'Ill..D~30 N o y PI u...()e.s.~ E7. Did you stop taking ON ON ON ON pili because or side PILL?Ez.. effects? Oy OY OY OY E8. Did you ever take ON ON ON ON birth control pills at (' ILl-OHII QILLDTl-'I~ any other time? OY OY OY OY - • Page 10 of 72 • .~ 45032 DID YOU EVER USE BIRTH CONTROL SHOTS OR IMPLANTS? N Y • 1 3 ~ecord M~1 month and rn :::d4o\ \ 5-16<.... '" ~ year nrst/next took OJ birth control shots or rno mo implants ITIIJ ITI..IJ [Ill] ITIIJ year :;fWr ~~T I year 5Hm'i~-r:z... year :>floT\t:>T ~ year "S>\1OT'P'-u, E10. Record month Sf-IaTKE,.lz.... and year stopped for OJ 5 HOn-\E>lI OJ OJ :5 t-IOTt4eN?> OJ :> l1arNeJ't at least 1 month using mo mo mo mo birth control shots or implants Ifstopped and started shots/implants, work out start and end dates for each separate episode Mark SHOT on calendar ~ttarIHP~ ~ E11. Was it a shot or 5HCT!fH..P/ :>rioTt 11.1 P2 ::> Ti'"P'-! implant? 0::0 shot I,)) Implant o shot 0 implant o shot 0 implant o shot 0 implant E12. Brand and dose shotlimplant used OJ].5f/I5W£/ OJ] OJ].:5tf07~ (SHOW CARD) CODE CODE CODE E13. Why dId you take thIs shot/Implant? (SHOW CARD) 0 \ 0 I 0 I 0 I ,..B.i.rth Control ON o Y5HOT(lC.1 ON o Y .5 Ho,I'>CL ON o Y5,/KJTtt.3 0 N OY~ Control heavy periods ON OY5ItOn,rDION o y:stJoTH-POz.. ON o Y5HOTffP~ 0 N o Y5HO'IHPO,/- Treat paInful periods ON o YSriOTPrO I ON o Y.5r:JOTPPV 2- ON o Y:,?fDfPPV30 N o Y.:>Hort'PP'f Treat acnefskin ON a Y5Hofl\uJi 0 N o Y.5110TfluJ Z- ON o Y.5!iiJ,ppJ30 N o Y .5fitJ~'f Treat endometriosis ON OY.5HOTaJDloN o Y.5HoTE.,..JD L ON o Y:5fiOT&J030 N OY~""'~NDtr Treat ovarian problems ON o Y5ffo,O<1P, ON o Y:5HOTDuPz.. ON o Y-5rJ(JWJf3 0 N o y:>fl6CiJJrt such as ovarian cysts Treat PMS ON o Y5iJliTP"'~' ON o Y .sttoTF!'I~ ... ON OY~TP~30N o Y ~IJ6TI'I-t> 'f Other reason(sp): ON o Y5HOWfIS 1 ON o Y Sl7tJTO~z.. ON o y:s"oTDe:,~ 0 N o y.5HOTiJ'S ~ E14 How often o -: 0 Once a month o Once a month o Once a month o Once a month did you get them? I ;, 0 Every 2 months o Every 2 months o Every 2 months o Every 2 months «1 1.-: 0 Every 3 months o Every 3 months o Every J months T o Every 3 months l:- t: I- :>1l"-(0,,1'1 0 Every 8 months II.. o Every 6 months o Every 6 months Every 6 months 3: a lL o 1- l t.f:: 0 One time only " o One time only G o One time only o One time only ~ ~ ~ 5-:. 0 Other(spi o Other(spi o other Page 11 0172 • ._---,. .•._--, __ • .~ 9314 HAVE YOU EVER HAD A BIRTH CONTROL PATCH OR RING? N Y • ID Number 2 4 Eie. Record monU1 rn PIt tJ br ~ ";i\z.. rn ~l ,.Jb.{'<\.,::>T t+ and year first/next used birth control mo mo patch or ring ITIIJ ITIIJ ITTIJ ITIIJ year ~\I·Jb"-l:>TI year P!1...,Jb'l::'-l:L year fZJwlS'-f'<:>T~ year RIt-.)6.\.p>I'1 E11. Record month n ., [IJ rlINC::lMCN\ rn R.lN~['(\E., -,..... L rn R1Nb«\'<::N~ 00 ~\ ...... o.rnE.~'-t and year stopped tor i\ at least 1 month u"lng rna rna rna rna birttl control patch or q;I;;g ITIIJ ITIIJ ITIIJ ring year INb.'iE.tJ I year ~INb"'EtJl- year 8.,Ne.'1EtJ"'3 year Klt-J6.\.fEN If Ifstopped and started patches/rings, work out start and end dates for each separate episode Mark. PATCH on calendar p,.TR.\~b.2. flP\T~[N~~ PA''''-''''''~ E18. Was it a patch fA" I< ,";'", P or ring? o patch 0 ring o patch 0 ring o patch 0 ring o patch 0 ring E19. Brand and dose ~ patch/ring used om Rolhl'l"-' [[IJ Ri be\2-z.. [IJO ",..s"'ee.~ om RII""51'-'t (SHOW CARD) CODE CODE CODE CODE E20. Why did you take this pan:h1rlng? (SHOW CAROl D , 0 I c I 0 I ..airth Control ON o Y K'''''''&.I ON o Y g.rJbP.;.C.l.. ON o Y il",""Clt3 0 N o y 1<':..ltJ6.&.q. ~ulate periods ON o Y \{,NC>PD' ON o Y Pi"", PDz.. ON o Y 1'-<>.l1>PD!.O N o Y \l.'"'''Pl"! Control heavy periods ON OY~lpJbL-\fDI ON o Y RUJf:o.t'lPD L ON o YI(I.J6iI l"tF'Pl:) N OYRi.J~L"PPlf- Treat painful periods ON o Y R,"'''PPD' 0 N OY ll.'''''''~~Dz.. ON o Y "'tJ.. ~P D30 N o Y(l..I~f"'D4 Treat acne/skin ON o YIl,,"'''fIUJ ION o Y R,!Jb(-\ouJl.. ON o Y R,"""~<.>1lo N o Y R,tJ>,PL.tJ'I Treat endometriosis ON OYR"J",e"D'ON o Y Rt~f:oe;Ni)L ON o Y R.')~E>lD:3o N o Y Ftl~b~~t:>'t Treat ovarian problems ON o Y\\,.,,,,,up, 0 N o Y R.1~brc::..,Jf Z- ON o YR",,,OOP.30 N o Y RI,..)6(:]uf"t such as ovarian cysts RI"J61Prl\~L Treat PMS ON o YI'-. ,~"'''",' 0 N o Y ON o Y R,..J"pk.53Q N o Y R.":"'P)-\,'1 Other reason(sp): ON o Y fI'N"OCI ON o Y R,uc..c.~z.. ON o Y R,u<>l\<;'30 N o Y (2., u6, Ce...:. 't E21. How often 0:: 0 Once a month o On<:e a month o Once a month o Once a month did you get .,.. them? \::: 0 Every 2 montha o Every 2 months o EVtlry 2 months o Every 2 monlhli r<) I- z..~ 0 Every 3 months N o Every 3 months 1- o Every 3 monthli IL o Every J months IL Q ~O Every 6 months ~ o Every 8 monthli 0 o Every 6 months -.a 0 Every 6 months RI.JbDf'f I 0 *0 One time only -I> o One tim. only cg o One time only '2 0 One time only '2 W 6: 0 OIherlspl o Other(sp) oL o Other(lip) o OIher(sp) c! .... 3~ 0 Don't know o Don't know o Don't know o Don't know ~ Did you ever use ON ~.Jt.ClTH~ ON l-_..ch or ring at any ttl,.Jb,oTt'\"l- o N \<., "'.. - 1 2 3 4 t.~3. Record month [J] \iJDl"I~TI \iJ 0 t'I';)TL \uO{<\~T:, and year first/next rn rn CD \ l.l1:::> '"'"'t used an IUD rno rnO rno rno [IT]] [IT]] DID ITIIJ year luO,/::>,1 year \ 00'/::>12- year ILJD'j~T::S year 101:>,/""'+ E24. In what month CD\uON£~\ [J]\UDl-IE,.lL [J] \uD14EtJ3 and year did you stop CD \UOMEo-l't using this IUD? rno rno rnO rno ITIJJ [IT]] ITllJ DID year IUD-jEtJ \ year 10D'/EN L- year IiJ DyE."'! ~ year ILJ D'I EOo-l 't (Mark IUD on Calendar) T'I pe:,uD 1 T'fPcILJ0 '" TyPElLiD3 TYP£IUO'-/ E25. What k.ind ()= 0 Dalkon shield o Dalkon shield o Dalkon shleld o Dalkon shield of IUD did you have (this time) ? I ~ 0 Plastic {Ioop,coill o pt...tlc Iloop,coilJ o Plastic (Ioop,coll) o Plastic Iloop,coilj (SHOW CAROl z.: 0 Copper o Copper o Copper o Copper 3:, 0 Progestasert o Progestsliert o Progestasert o Progestasert ~;; 0 Mlrena,LevoNova o Mlrena,LevoNova o Mirtlna,LevoNova o Mlren.,LavoNova 5: o Other(sp) o Other(sp) o Otherlspj o Other(sp) _ :3:: 0 Don't know o Don't know o Don't know o Don't know IUDHPm J / UDHRffI Z- IUDtieM$ /uDHem't E26. Was the IUD O IUD6Tftli /LlDOTML. /LlDorN :, JlIDoTl-<'f E27. Old you use an 0< ON ON ON ON IUD at any other time? I~ OY OY OY OY - • Page 130172 • ------.~ DID YOU EVER HAVE A TUBAL LIGATION? N Y 9314 • TLJ0L.-MO _28. In what month and year did you have your tubal CD ligation? (lubes tied) month (Mark TUBAL UGAnON on Calendar) E29. When was your tubal 0::: 0 During C-section or other open surgery in a hospital ligation done? I -:.= 0 Within 2-3 days after you delivered vaginally (READ first 3 responses) 1LJI?LCbME: ;;I =0 Other, sp _ .,~ 0 Don't Know E30. Was your tubal ligation 0-.::' 0 By laparoscope ,.....c.erformed by laparoscope or J c 0 Vaginally Iginal operation? _ ~ ~ 0 Don't Know 'fUBLHETH -- • Page 14 of 72 • .~ SECTION F: HYSTERECTOMY 37453 • 10 Number \ Dr-!uff\ . NQuid now like to ask you about certain operations and medical conditions that you may have had. F1. Did you ever have a myomectomy, which is ON removal of tissue or fibroids from your uterus, without removal of the whole uterus? OY F2. Did you have a hysterectomy, that is surgical o N (Go to Section G) removal of your uterus, before ""REF MO YR·? o Y /-1'f:=' TE! rno H'f':,rf.., 'i«, H'I~TR.... F3. In what month and year did you have your hysterectomy? [D;[]IJJ mo year Mark HYST on calendar He! ~ T I!.E:Its, {)-:: 0 Birth control e::."'O Ovarian cyst F4. What was the reason for your hysterectomy? (SHOW CARD) I. 0 PID complications q. 0 Prolapsed uterus l.':- 0 Tubal cyst 10- 0 Endometriosis .s,:- 0 Uterine cancer 'I:: 0 Cervical cancer 'i" 0 Abnonmal bleeding 1",0 Myoma 5 r 0 Adenomyosis J~O Other cancer, sp '" = 0 Fibroids I 'f' 0 Other, sp 1" 0 Pelvic Pain NOS F5. Was the hysterectomy performed cJ~ 0 Abdominal by an abdominal or vaginal operation? I ~ 0 Vaginal F6. At the time of your hysterectomy, were ()~ 0 No any ovarian cysts removed? I" 0 Yes, from one ovary ove'! Rf!M z.:, 0 Yes, from both ovaries .3: 0 Yes, but don't know jf one or both -.3"" 0 Don't know if any cysts were removed F7. At the time of your hysterectomy, was 0= ONo either ovary removed totally or partially? I" 0 One ovary out, total 01/ite. R..E M V 2:= 0 One ovary Qut, partial '3 : 0 One total, one part,al 4-:' 0 Both ovaries out, partial - 5.: 0 Both ovaries out, total - 3 ...- 0 Don't know ovarian status • Page 15 of 72 • ------, .~ SECTION G: PELVIC AND OVARIAN OPERATIONS 37453 • - '--' I. Have you ever had a laparoscopy for other ON LAPNQTOV reasons other than ovarian surgery or tubal ligation before "REF MO YR"? OY IIyes: G1.1. What was (were) the reason(s) for the laparoscopy? List all the reasons that are recalled: Reason 1. LA PiEA~ I OJ Code Reason 2. L.I\ P/(EA:s z... OJ Code L.APj(E"fi::>~ Reason 3. OJ Code LA f t.EA ':> 'f Reason 4. OJ Code ..(;2. Have you ever had other surgery on your aNa domen (belly) or pelvis? OTi-IAGOS!?, o Yes-once a Yes-more than once IIyes: G2.1. What was (were) the reason(s) for the surgery? Us! all the reaSonS that arE' recal/ed: Reason 1, f16D 12.Cf\:;, I OJ Code Reason 2. A-6DeEA ::> l. OJ Code Reason 3. A 001U.fl'53 OJ Code Reason 4. A0DU~Y OJ Code • Page 16 of 72 • ------ .~ 37453 • G3. Have you ever had any operations on your ovaries before *REF MO YR ON (Go to Section H) ( - "than during a hysterectomy) OY OVAf.OP OP 1 OP 2 OP 3 OP 4 G4. In what year was OflOVAIC. OP"OJA!'-. oP~ouf\i... QP'+OvA~ the [first/next] operation on your ITIIJ ITIIJ ITIIJ ITIIJ ovaries? year yea r year year (RECORD OVARIAN OPERATION ON CALENDAR) G5. Which ovary o Left o Left o Left o Left was involved?· I'" o Right o Right o Right o Right o Don't know o Don't know o Don't know o Don't know O\Jf> 0 I 0 1 0 0 1 Cysts ON o YC~ST Dont' know ON o Y DY-OPI ON OY DKDPZ. ON o Y D<.OP3 0 N OY DWf,/ b7. What was done to your ovary? (SHOW CARD) 0 I D I 0 I CJ I YPfltrlZC",~ Partial removal ON o Yffl ..Te.E" , ON o Y PflUtE"I- ON o N o Y Pp,,,,U,,,q BIopsy ON o ye,IO/O" I ON o Y P.HCI'OJ l.... ON o Y P.;idPoJ3 0 N o y (3.10POv''I- Exploration ON o YE~P~1l.1 ON OY E'P~~I- ON o yE~h,~?> 0 N o Y E'Jt Pt-£....'f Tom! removal ON OYTore..~1 ON OY'O,f<£ML ON o YTOTIU'N!>J N o Y TbTI'.£M'f Scraping ON o Y '.:(jj\y"I ON o Y see-AY£ '- ON o YSUf'I Pf.3 0 N o Y SL£ilf'!:'t Other,sp ON OYOTDt-!WI ON o Y cJTDiJOJz.. ON o Y OTD>JoJ3 a N a Y oTO ,,"OJ 't Cyst removal ON o YUf~TUH ION o YCLf:>Ti2EM /... ON o VC-Y~T,z.EJ1X, N OYC'l"UM~ Cautery ON OYU\UTERI ON o Y CAlJ71?:/Z. 2.. ON o YU't Don't know ON o YDKJ),JoJj ON a YDKDiJMz... ON o YDJ!.[».!M3 0 N o Y Dt.J)NOU,/ G8. Have you had OTOvOf' 1 cJTO 0, le ovary reported, ask: "Was anything done to your other ovary during this operation?" If both ovaries are involved during one operation, code as separate episodes. Always code LEFT ovary first. • Page 17 of 72 • .~ SECTION H: HORMONES 10559 • 10 Number \ DNU f'J\ Now I have some questions about female hormone medications that you may have used for reasons other than birth control. Please tell me about medications that you haven't already told me about. These medications may be in the form of a pill, shot, skin patch, vaginal cream or suppository. H1. Before *REF MO YR· , have you ever taken medications: (SHOW CARD) 0 l O. For menopause? ON OY Rx.He>-lOP 1. To treat osteoporosis ON OY l'-'" 0 :Y, i:. ot' 2. Prescribed after hysterectomy or removal of your ovaries? ON OY R~Af I~'fST 3. To regulate periods? ON OY P." IU=:& f 0 S 4. To control heavy bleeding? ON OY 0.><. I·t 1O>L.G.E:D 5. To treat painful periods? ON OY \,-", ~fOS 6. To bring on a late period? ON OY P. ... \"-<"I'T E. F"I:> 7. To prevent a miscarriage? ON oy (-\ " NO 1-\\",, -- B. As a morning-attar-pill? ON OY f<. )U·-\ fW 9. To test for pregnancy ON OY I"e~-r \'I"-E6, 1O. To treat endometriosis ON OY (Answer J3) Rl 11. To treat ovarian problems, such as ovarian cysts? ON OY (.l.l< 0 " c. 'iSf 12. For the treatment pf pre-menstrual syndrome? ON OY Rl< ~ lV\'" 13. For any otharreason? (sp) ON OY t-1\<.t<\OT,W,S • Page 18 of 72 • .~ 10559 • (Ask of women never on hormone replacement therapy H1.0, H1.1 and H1.2 are "No") H2. Were you having any menstrual periods in the 6 months before II REF MO YR"? "" 0l./1';'\' D 'IP, W\.,T f D If NO, not having periods H2.1. In what month and year did you have your last period? [D/[IIJ] rna year (Mark LMP on calendar) (Ask ofwomen on hormone replacement therapy H1.0 or H1.1 or H1.2 are "YES") H3. Did your periods stop before taking a hormone medication? If Yes, periods stopped before taking hormone medications, H3. 1. Why did your periods stoP? ():: 0 Menopause 1< OSurgery WI+jNOfVS, Z. ~ 0 Chemotherapy 3 ~ 0 Other, sp - ., ~ 0 Don't know If Yes, periods stopped before taking hormone meds, H3.2 In what month and year did you have your last period prior to MO YR" "REF rna year (Mark LMP on calendar) H4. Have you noticed any of the following menopausal symptoms: (SHOW CAROl D \ -., 1. Night sweats ON OY OOK ~~WE~,~ 2. Vaginal Dryness o N 0 Y 0 OK v A.G 0"-'1 N "> 3. Hot Flashes ON 0 Y 0 OK \-\0\ f' \..f\~ 1-\ If Yes to any symptom, H4.1. At what age did you start having the first of these symptoms? OJ age (years) • Page 190172 . • --_._.__ --._------ ~ IF EVER USED PREMPRO OR PREMPHASE • 10559 • f-J"-. Look at this photo of honnone medications in a bubble pack. On the right is I npro, which contains a single pill that you take every day of the month. On ON (go to H6) the left is Premphase, which contains one pill that you take the first of the Y f'\2£",~ "'0 month and a second pill that you take at the end of the month. Did you ever o take either Prempro or Premphase for one month or more? (SHOW PHOTO) IF EVER USED PREMPRO OR PREMPHASE We want to record information about each period of time in which you took either Prempro or Premphase continuously for at least ane month. 1 2 3 4 H5.1 which of these 0::. 0 prempro o Prempro o Prempro o Prempro is the [firslfnext] Premphase Premphase Premphase o Premphase hormone pill that you I"" o o o took? -::, ODK ODK ODK ODK ~~~e>'\\ f I'MI'\Cl'I '- r1<\'\ ~ \2.\'1\ ~ PeMI' 1'-1-\ "r H5.2 Why did you take this pill? (SHOW CARD) To treat menopause-related ON o Y ~(!'1l\.1l>lIO N o Y PePl1-'1t>\Z- 0 N o Y I' fZ,f~"",J 3 0 N o Y P"-1~"""'t symptoms To treat depressIon, anxiety ON o Y Pl\f~ptrl 0 N o YPUWtl'l.o N o Yfl?f~Otf!> ON Oyl'tP~D6P'1 emotional distress For replacement U1erapy o ~e1t~11-110 N o yPI'.PL~JZ:l"l.o N o yPl2..1 L"L' ~ 0 N o y i'i2.P f2.»U'j a""~ hysterectomy ON T ~t or prevent osteoporosis (bone ross) ON o yPOl'JY.,TI 0 N o yPe.PlW>T1. 0 N o y f12 Pet»T3 0 N o y Pl2.Pe.O>T't To treat or prevent yP~1~c.'\llz.o cardiovascular disease ON o yPep(UJD10 N o N o y PeRll.c.u D;!> 0 N o yPI2.i'l1Lv D$ To regulate irregular periods ON o Yl'12PI HS.3 . At what age did you start taking U1e hormone OJ OJ OJ OJ pill? BgB~YBBrs) BgB (YB8fS) aga (years) 8ge (years) p,,", A0€\?\ HPA6 H5.4 . At what age did you s!op for alleast one OJ OJ OJ OJ month taking U1e hormone age (years) age (years) age (years) age (years) pill? ('~~ f\Ci..I:.'? \ PI<. PAbE S 2 Pl1:.fA&lS9.> Pl1.PA6.E. '=''t (Mark HRT on Calendar) HS.S. Old you ever take ON ON ON ON Prempro or Premphase at anoU1er time for at Oy Oy Oy Oy le.,a.s.t one month? pRP~OTIV1I FR,Pt<:OTI4 L PJ?ftoTH :, PRfi?OTH't (USE CONTINUATION PAGES IF NECESSARY) • Page 20 of 72 • ---- .------_._--_._------_..._---- ~ IF USED PREMARIN • 10559 • H§...Look at this picture of honnone medication. It is called Prema.in. Did you ON (go to H7) e take premarin either alone or in a combination with a progesterone (such o as Provera) for a period of at least one month? (SHOW PHOTO) I Oy -?:J o DK IF USED PREMARIN We want to record information about each period of time in which you took Premarin continuously for at least one rnonth_ \'RE.t-I,,-b~ P~t-\FZ.O.s1.... 3 I f' WI-' ~O::'"3 P§%NRD~'+ H6.1 What was 0= 00.3mg o 0.3mg 00. mg o . mg the dose of 1= 00.625 mg 00.625 mg 00.625 mg Premarin you 00.625 mg took during this z.. 00.9 mg 009mg 009mg 00.9 mg episode? (SHOW PHOTOS) 3= 01.25 mg 01.25 mg 01.25 mg 01.25 mg 4~ 02.5 mg 02.5 mg 02.5 mg 02.5 mg S = 0 Other(sp) o Other (sp) o Other (sp) o Other (sp) ~ :3 -'" 0 Don't know o Don't know o Don't know o Don't know N M Pr H6.3 Why did you take Premarin? (SHOW CARD) To treat menopause-related ON o y f'l(I1eHWIO N o y PUle.t1EIJl.o N o yPfJ-i~,,JJo N o y PIUUN0,.)4 symptoms To treat depression, anxiety ON o y PRoli ROoPI ON o yPIi,M(ocl'z..O N o yP£.fj~1lf:I'30 N o y I'I/.NI( ~ j.4. At what age did you st.rt taking Premar1n? age (years) age (years) age (years) P«MflGe';L P{{rn~cS 3> f~M6Y\ H6.5 . At what age did you stop for at least one rn rn rn month taking Premarin? age (years) age (years) aga (years) age (years) (Mark HRT on Calendar) H6.6 Did you take a pJ(06Esrl PR06~TL PI206E~r 3 PR1:J66sr H6.6.1 What was the PI2~ BRI PI?06BRz.. pe06 1:>/2. estrogen o Day took estrogen o Day took estrogen o Day took estrogen were t('Jking this progestin, did yoJ = 0 Only certain days o Only certain days o Only certain days o Only certain days take it: -3: 0 Don't know o Don't know o Don't know o Don't know PRI-iOTN/ PRl-iDTH Z PRl-iD77'-f 3 P£/-fDTN'f H6.7 Old you ever ON aN ON ON Prenlann at another bme for at least one OY OY OY OY -'onth? (USE CONTINUATlON PAGES IFNECESSARY) • Page 22 of 72 • .m IF USED HORMONE PILLS 37851 • ID Number , " . Look at this picture of hormone medications. Did you ever take any of ON (gotoHB) these pills either alone or in a combination with a progesterone (such as o Y I-\O~N Y'1l-L Provera) for a period of at least one month? Remember these are hormones used for reasons other than birth control. (SHOW PHOTO) IF USED HORMONE PILLS We want to record information about each period of time in which you took a honnone pill continuously for at least one month. 1 2 3 4 I. ~r..J1-\ H7.1 What was the HM----- PN"" Ii 1'\ 1 IiMPNM,=, Ii MPtJM,\ name of the [rlfsUnext] hormone pill you took [IT] [IT] [IT] [IT] from this card? CODE CODE CODE CODE (SHOW CAROl Pd"l PO:> I f\tlW \/~2. I-JMfD~3 HMPDS,\ H7.2 What was the dose 1 [IT] [IT] [IT] [IT] i2il/s pills pills pills I-tM ~TM \ \-\ ... rTM 7 Ii MP,M:, ]-\ ti I'TH H7.3 Why did you take this pill? (SHOW CARD) To treat menopause-related ON OYftHPM"~ION o YliMP/o1EJJZ. 0 N o YIIMPMe>iJO N symptoms To treat depression, anxiety ON o YIi", rD~' 0 N o YHliPDZFz.. 0 N o yHI1PD"'30 N emoUonal distress For rBplBl:ement therapy after a hysterectomy ON o Y HMftH2r z. 0 N o YHMPItR:r3 0 N To treat or prevent osteoporosis (bone loss) ON o YI1~~O~TI 0 N o YliHPO~TL 0 N o YHM rO}T30 N o Y t-JI-' PO ;'7,+ To treat or prevent cardiovascular disease ON o Y Hl-1pc"o 10 N o YH,"P,,-vD2 ON o yHMPuJDJO N OYHI- To treat another disease ON o YHHPOO~I 0 N o Y»HPOD~:z. 0 N o yrl"POD;,3 0 N OYHHPOO''t Other reason (sp): ON o YH,"PQf ~. ,The pill you were f-\ HRb. \ fH'n6.L HPn~G.3 l-tf feb,! taking is a type of estrogen. ON ON Did you take a progestin or ON ON progesterone pill such as OY OY OY OY those shown here? (SHOW PHOTOS) (if not, go /0 H7. 7) f-lff~Uz.. n~~ H7.6.1 What was the \-\PPRb&\ ItP I'I<...e ~3> 1'IP e,e.'t name of the progestin pill you took with the ITIJ [IT] ITIJ [IT] estrogen? (SHOW CODE CODE CODE CODE CARD) NtJI\WP~\ N" f\(PRk,L Nt-·\l-I f f e.E, 0> NMtlfP\2..",+ H7.6.2 What was the dose? ITIJ [IT] [IT] ITIJ pills pills pills \~ \' \' l~Tt-I \ 1-1 PPRbTHL HfPI'-bTH3 Ii f FR.E"I'-\ Y o =- 0 Per day O Per day o Per day o Per day ,~ 0 Per week o Per week o Per week o Per week 2.: 0 Per month o Per month o Per month o Per month 3 =- 0 Per year o Per year o Per year o Per year - - 3"" 0 Don't know o Don't know o Don't know o Don't know HP\,i:.6.Wlt\ HPPR~WC\L 1-\ ffR(, UJ Ii3 Ii ppe6W~J'f H7.6.3 When you 0= 0 Every month o Every month o Every month o Every month ware taking this progestin, did you 1::- 0 Every other month o Every other month o Every other month o Every other month take it: 1.,.= 0 Every three months o Every three months o Every three months o Every three months 3::- 0 Every fourth month o Every fourth month o Every fourth month o Every fourth month -1: 0 Other (sp) o Other (sp) o Other (sp) o Other (sp) -:3::0 Don't know o Don't know o Don't know o Don't know HNPPROE.\ Hf{fr~(,Z- 14M!' P~OE. ~ HMff'R06.'t H7.6.4 When you cp 0 Day took estrogen o Day took estrogen o Day took estrogen o Day took estrogen were taking this progestin, did you (= 0 Only certain days o Only certain days o Only certain days o Only certain days take it: -3 o Don't know o Don't know o Don't know o Don't know HM foT/l-l HHfOTI-'<' HMPOTH3 H7.7 Did you ever take ON ON ON any other hormones at any other time for at OY OY OY least one month? (USE CONTINUA TlON PAGES IF NECESSARy) • Page 24 0172 • ------IF USED VAGINAL CREAM, SUPPOSITORY, TABLET OR RING ·rn37851 • H8. Did you ever use a vaginal cream, suppository, tablet or ring contaIning ON (go to H9) -- ;trogen such as those shown on this card for at least one month? Remember these are hormones used for reasons other than birth control. OY V~U;i...M (SHOW PHOTOS) IF USED VAGINAL CREAM, SUPPOSITORY, TABLET OR RING We want to record information about each period of time in which you used a vaginal cream, suppository, tablet or ring continuously for at least one month. 1 2 3 4 H8.1 What was the name of the [firsUnext] vaginal cream, supppository, ITIJ [ITJ tablet or ring you took? CODE CODE CODE (SHOW CARD) HB.2 How many VGc. 1<-".'>3 times per day, [ITJ weex, month or timas times limes times year did you use V c:,C,,"TK \ >J G.('~THL V6,c...e.-TH 3> V(,C.12-TM,\: the cream or 0.: 0 Per day suppository? o Per day o Per day o Per day l ~ 0 Per week o Per week o Per week o Per week 1..,. 0 Per month o Per month o Per month o Per month --- 3 ,. 0 Per year o Per year o Per year o Per year _ 3; 0 Don't know o Don't know o Don't know o Don't know HB.3 Why did ynu take this cream, suppository, tablet or ring? (SHOW CAROl V&::...t2.J-1E~ I \J6.L$Z.HEU2 v&.c. f.2.Ht::U.3 "GC. R. ~ E.1Jl.f To treat menopause-related ON OY~' . ON OY ON OY ON OY symptoms V~C.e...DE:PI v~c:....It-.ot:.PL VGoc..12. Dc"':5 \/GC.f20EP'i To treat depression, anxiety ON OY ON OY ON OY ON OY emotIonal distress vc,e£.l-tI2.TL For replacement therapy V'"cl1./-t £.TI V6C12. H I2-T .5 .,{If;C ILIi /2;"+ after a hysterectomy ON OY ON OY ON OY ON oY To treat or prevent VGGf..o"T I IjGCA2.0"Tl. VGC/Ul~T3 "{GC.l:dST 'f osteoporosis (bone loss) ON OY ON OY ON OY ON OY To treat or prevent 1/ GCQC.,{OI VG GUV05/. vGc.eCJD3 vGC.R.cvD'f cardiovascular disease ON OY ON OY ON OY ON OY '6~O~Of IS~C'6'VD~ VGCJ<.RI'D H8.6 When using this vaginal cream, suppositpry, tablet or ring did you take a progesterone pill such as those shown here? (SHOW PHOTOS) (if nor. go fo H8.7) H861 What 'N H8.52 What was the dose? pills pills piffs pills \J L. f'~6 TI-t\ v C I"l!.(,.Tf-l\ 'ole PRe, '11.1 Ve. pRt:; 1M I D 2 0 Per day o Per day o Per day o Per day L ~ 0 Per week o Per week o Per week o Per week 2-" 0 Per month o Per month o Per month o Per month 3 C' 0 Per year o Per year o Per year o Per year _ ? ~ 0 Don't know o Don't know o Don't know o Don't know "e. Pk:qW>I I VC PRbWHaz.. ve. PI<6.WM3 VC.P~4WH'i ~~8.6.3 When youO _ 0 Every month o Every month o Every month o Every month 'ere taking this - progestin, did you I -:: 0 Every other month o Every other month o Every other month o Every other month lake it: L:: 0 Every three months o Every three months o Every three months o Every three months 3::: 0 Every fourth month o Every fourth month o Every fourth month o Every fourth month 'f" 0 Other (sp) o Other (sp) o Other (sp) o Other (sp) - 3:::: 0 Don't know o Don't know o Don't know o Don't know VG.c. Pf. VG.C OT/-{ I VGoCOTM Z V(£.OII-/:=, V6Ul'NY. H8.7 Did you ever use an ON ON ON ON estrogen vagInal cream, suppository, tablet or ring OY OY OY OY at any other time for at least one month? (USE CONTINUATION PAGES IF NECESSARy) • Page 26 0172 • .~ IF USED ESTROGEN PATCH 43948 • IDlWJmber H9. Did you ever use an estrogen patch such as those shown on this card for ON (go to H10) at least one month? Remember these are hormones used for reasons other o Y 0::>TPA-H.\\ than birth control (SHOW PHOTOS) IF USED ESTROGEN PATCH We want to record information about each period of time in which you used an estrogen patch continuously for at least one month. 2 4 H9.1 What was the E. ['ATLtl., name of the [firsUnextj estrogen patch that [ll] [ll] CDJ you used? code code code "'de (SHOW CAROl H9.2 How orten did you use the palt:h7 pills pills pills pills ~I'ITL"TH \ -p An.'F 1--\ Z- 9 '"l"U-\rn "3 PI\-"It_.i.l-, '\ D= 0 Per day o Per day o Per day o Per day I ::" 0 Per week o Per week o Per week o Per week .3.:, 0 Per month o Per month o Per month o Per month 3 ~ 0 Per year o Per year o Per year o Per year _ :3 = 0 Don't know o Don't know o Don't know o Don't know H9,3 Why did you use this patch? (SHOW CAROl ~ATi-\bJ \ PATHe;-0--> z \'1I-T1-',,->J ~ f'ATH8-lU, To treat menopause~related ON OY ON OY ON OY ON OY symptoms Pr-v-roep \ 'i'II-TOEfz. >' / 171\,q.""' >-I \ Pf\'c..HW~ '- 17 f\K~ ' H9.7 When using this E.~~~\ t:: Fr fk.1. E:FPfk.~ E-1 fet;.,-\ estrogen patch. did you take a progesterone pill ON ON ON ON such as those shown here? OY OY OY OY (SHOW PHOTOS) (if not. go to H9.8) H9.7.1 What was the name E.1 r~~ e>l2- \ E frR,u B\CL Efre<'\:,Ii:> E PI'i IF USED ESTROGEN, TESTOSTERONE, OR PROGESTERONE SHOT We want to record information about each period of time in which you used an estrogen, testosterone, or progesterone shot continuously for at least one month. 1 2 3 4 H10.1 Whatw8sthe I\S\\OT\ 1-\51101;) H::>ltoT;? 1-1;:, Har,"! name of the hormone shot that you used? ITIJ ITIJ ITIJ ITIJ (SHOW CARD) ood. code code I~:'> I-\OTos, I H10.2 How many ITJ]5 7 [f]]P;,'t times per day, week, month or ITIJ times times fimes times year did you get H~l\oTT}\ \ j-\::> I-\OTTH 7. li~HoTTH3 HSHOT TH'j this shot? Cl 0 0 Per day o Per day o Per day o Per day 1$ 0 Per week o Per week o Per week oPerweek 0>' 0 Per month o Per month o Per month o Per month .3 "11 0 Per year o Per year o Per year o Per year - 3 0 Don't know o Don't know o Don't know o Don't know ..-. 3 Why did you take thiS shot? t.... ,VW CARD) l-t~'" EJJJ 1+:> N eN 7. H:>HCIV?> H5HOI'f To treat menopause-related ON OY ON OY ON OY ON OY symptoms H5DEP/ H5C?EP;z. I-t~ D£.P3 1"'1 SDEf',*, To treat depression, anxiety ON OY ON OY ON OY ON OY emotional distress 1+:> HRf2. /-I5HIZ..13 ftSH I2.T't For replacement therapy If-:::> It"" after a hysterectomy ON OY ON OY ON OY ON OY To treat or prevent 11 sroTl J1.s0~TL HSosT3 H.5=Ff osteoporosis (bone loss) ON OY ON OY ON OY ON OY To treat or prevent IfSCVDI f-tSC.,fO z.. 1-1 S c.,f D 3 ftSC110 H 5 11 z..~ 0 Every three months o Every three months o Every three months o Every three months .J: 0 Every fourth month o Every fourth month o Every fourth month o Every fourth month -I: 0 Other (sp) o Other (sp) o Other (sp) o Other (sp) 5= 0 Don't know o Don't know o Don't know o Don't know H10.7 When getting this H.5HTPJt6/ H5Hrr/?62... It.sHrt't<63 11.5 H T P>/<. 't shot did you take a progesterone pill such as ON ON ON ON those shown here? OY OY OY Oy (SHOW PHOTOS) (it not, go 10 H108) H10.7.1 What was the /+SPRbrl3l2.l H:>P/?613f?Z. I+5PK6 B"~ H:>PK6 B.e.'! name of the progestin pill you took with the hOrmone ITJJ ITJJ ITJJ ITJJ shot? (SHOW CARD) code code code code NM. Hs PR6z. NNIISPK6.3 !JNI1 SFR6'f H10.7.2 What ND]]R&/ was the dose? ITIJ ITJJ ITJJ limes times times times tt~ PR9 TI-; I t-t5 PRG,rNl. IT!, PR..n.., 3 I+!, 1'1<<; Ti'1 't ,;,;;0 Per day o Per day o Per day o Per day ,- 0 Per week o Per week o Per week o Per week d- ~ 0 Per month o Per month o Per month o Per month .J: 0 Per year o Per year o Per year o Per year _ ?r 0 Don't know o Don't know o Don't know o Don't know 1+.5~fJ,6.>.J1I, IT5 PKf,oJIIL IT5PRE ILJ N 3 j-f.5 P Il ~ I. U:;E: D~S H11. Did you ever take DES (diethylstilbestrol) for at least one month? 0_- ON (gofoH12) (::c OY IF USED DES We want to record information about each period of time in which you used DES continuously for at least one month. 1 2 3 4 \JeSQ~\ 1)E':>OYZ PESv~~ OESD:>'t H11.1 How many DES pills did you take? rn rn rn rn illS pills pills pills De o,n\l DE~Mz.. L:E.":>TM3 DtSTM,* 0; 0 Per day o Per day o Per day o Per day l.& 0 Per week o Per week o Per week o Per week 2 • 0 Per month o Per month o Per month o Per month 3:= o Per year o Per year o Per year o Per year _ ~~ 0 Don't know o Don't know o Don't know o Don't know . Dt:..J~;l\ DE'~W H;I"Z D5.:>...JH;(.?> D~;\:;l 'f H11.2 Why dldo:-O Prevent mise rriage o Preven misca age o Prevent misca iage o Prevent mise rriage ..1Pu take DES? - '::AD ALL) I::: 0 Treat/prevent cancer o Treat/prevent cancer o Treat/prevent cancer o Treat/prevent cancer 2-0 0 Other (sp) o Other (sp) o Other (sp) o Other (sp) VE5I\GoE~1 DE~bEB2.. ~AG£B3 b ESAoE13.'t H11.3 . At what age did you start taking DES? rn rn rn rn ag9 (y9ars) age (years) age (yeers) aga (years) H11.4. At what age did you stop for at least one month rn rn rn rn taking DES? ag9 (Y9ars) at*5~~ ab~ age (years) DESAbBI b1OS~ De:'>fI&E 5'1 -_._.,...... ,, H11.5 When youO::: 0 Every month o Every month o Every month o Every month were taking DES did you take it: I :: 0 Every other month o Every other month o Every other month o Every other month Z ~ 0 Every three months o Every three months o Every three months o Every three months 3:: 0 Every fourth month o Every fourth month o Every fourth month o Every fourth month 4 ~ 0 Other (sp) o Other (sp) o Other (sp) o Other (sp) - ,3:0 Don't know o Don't know o Don't know o Don't know DE5wH I D~"2.. De5WH 3 D~H't H11.6 DId you ever take ON ON DES at any other time lor 9UBBSt one month? OY OY D~DT,,", l r::E::;,oTH L • Page 31 of 72 • ~ IF USED RALOXIFENE • 62705 • '-"12. Did you ever take raloxifene (Evista) for at least one month? ON (go to H13) OY RAu:)x,F IF USED RALOXIFENE We want to record information about each period of time in which you used raloxifene continuously for at least one month. 1 P,ALC~ 0::>1 H12.' How many raloxlfene pills did you take? CD .,,- RA LOl<.TI-\ \ AALCl'-TML RA\4.Tl-\~ p..AL...Dx.TM 'I o ~ 0 Per day o Per day o Per day 0 Per day I ~ 0 Per week o Per week o Per week 0 Per week -z..:: 0 Per month o Per month o Per month 0 Per month ,: 0 Per year o Per year o Per year 0 Per year - 3 ~ 0 Don't know o Don't know o Don't know 0 Don't know ~L.",,-,-,,, R I..l<. "-l tly I R LX " ..HI'i L \2.1..>'.10 tli 3 'I '/ H12.2 Why dido=O Treat/prevent asleop a Treat/prevent asleop o Treat/prevent asleop 0 Treat/prevent asleop you take ;;ajoxifene? I ~ 0 Treat/prevent cancer o Treat/prevent cancer o Treatlprevent cancer 0 Treat/prevent cancer 'AD ALL) Z=' 0 Oth er (sp ) o Other (sp) o Other (sp) o Other (sp) RI..o (.(Lxw '" \ RLX W 1-\ z...... «.W<-lLlI-l3 I':I.. "u..l Wi H12.5 When you O~O Every month o Every month o Every month o Every month were taking raloxifene did you\ -:;:- 0 Every other month o Every other month o Every other month o Every other month take it 2.:' 0 Every three months o Every three months o Every three months o Every three months :3 ~ 0 Every fourth month o Every fourth month o Every fourth month o Every fourth month 4~ 0 Other (sp) o Other (sp) o Other (sp) o Other (sp) - 3;::: 0 Don't know o Don't know o Don't know o Don't know H12.6 Did you ever take ON ON ~oT""4 raloxlfeneat any other RI.l(OTN I ON (2Ul;oTfoI z.. ON time for at least one OY OY OY OY month?- (USE CONTINUATION PAGES IF NECESSARY) • Page 32 0172 • .~ IF USED TAMOXIFEN 62705 • :3. Did you ever take tamoxifen for at least one month? ON (gotoH14 OY TAMOX. t F IF USED TAMOXIFEN We want to record information about each period of time in which you used tamoxifen continuously for at least one month. 1 2 3 4 --rrnOb~ H13.1 How many TA[j~r~\ '-rn"'O'~"2- tamoxlfen pills 'ITi'7.it did you take? TF\ ll\t"TM \ 17'r1Y10X'M t Tl\ MOx.H-\ 3> TAMO"'''''~ 6 =- 0 Per day o Per day o Per day o Per day I ;' 0 Per week o Per week o Per week o Per week 2: 0 Per month o Per month o Per month o Per month 3: 0 Per year o Per year o Per year o Per year -3 : 0 Don't know o Don't know a Don't know o Don't know 1M"W H'I \ '"'"' >< ojtI'I 2 TI-<"lIJtt'1 3 TM> I"J..t )( UJ ~ t 'ffi; H13.6 Did yOll ever take ON ....., _ ON ttamoxlfen at any other I t-a'J,OI M \ o N ,1->11'011-11... ON Tfll><6TM3 time for at least one OY OY oY OY month? (USE CONTINUATION PAGES IF NECESSARy) • Page 33 of 72 • .~ IF USED TESTOSTERONE PILLS 62705 • li14. Did you ever take testerone for at least one month? ON (go to H15) OY TESToS IF USED TESTOSTERONE PILLS We want to record information about each period of time in which you used testosterone continuously for at least one month. 1 2 3 4 ,\O-::,Q::,I ,\O:>D:) 1- Ii?)SDS~ ITO~V~'t H14.1 How many testosterone pills did you take? CD CD CD CD TTD~T,,",\ ---rTbsrN -Z- TTO.>T.... 3 TTQ~rH't 0= 0 Per day o Per day o Per day o Per day I ~ 0 Per week o Per week o Per week o Per week AbEBI TT5'\6E;13z.. TTSI\6E.B3 IT5> Ft;,E. r.,4 H14.3. At what age did you start taking teslosb!lrone? rn CD rn CD -rr:sA6ESI TTSA6ES" TTSfl66S 3 TT.sA6E~'1 H14.4. At what age did you slop for at least one month OJ CD CD CD taking testosterone? age (yearn) age (years) aga (years) age (years) -rrD.5l.JItI 7TD5oJlTo, TT[l5tJ~3 TTQ)WII't H14.5 When youO=- 0 Every month o Every month o Every month o Every month were taking testosterone did I.; 0 Every other month o Every other month o Every other month o Every other month you take it: a..; 0 Every three months o Every three months o Every three months o Every three months .3;:: 0 Every fourth month o Every fourth month o Every fourth month o Every fourth month 4= 0 Other (sp) o Other (sp) o Oll1er (sp) o Other (sp) _ ~,:: 0 Don't know o Don't know o Don't know o Don't know TTOSOTN, TToyjT/YI2 TT{)&!Tf13 TTQ50TN'f H14.6 Did you ever take ON ON ON ON testosterone at any other time for at least one OY OY OY OY month? (USE CONTINUA nON PAGE5 IF NECESSARY) Page 34 of 72 • ~-~~~~------• - .~ IF USED HORMONE PillS 62705 • 15. Have you taken any other female honmones that we have o N (go taSeelion I) not discussed for at least one month? OY HMPIl.-L IF USED HORMONE PILLS We want to record infonn8tion about each period of time in which you took a hormone pill continuously for at least one month. 1 2 3 4 H15,1 What was the H fYWILLI 1-j(nP,u..2 Hm PILL~ HM PILL 'f name of the hormone? [[[] [[[] [[[] [IIJ H15.2 Why did you take? ood. code code code this pill? turn ..oJl H pmE/oJ Z. rtP rn "'" 3 1+ Pm"-tJ't O. menopuase related symptoms ON OY ON OY ON OY ON OY iTP p,., ~ I rtfP1-<:'z.. ttfp/Yl> 3 1-/ PI'f(J:''t 1. depression, anxiety, emotional ON OY ON OY ON OY ON OY distress PMS HPTfhtl ttPTIlM z. /1 P TIle 3> HP,IlH't 2. therapy after a hysterectomy ON OY ON OY ON OY ON OY HfFI3Ll /-tP PBL2. Ii PPBL3 HP P8/-'j 3. prevent osteoporosis ON OY ON OY ON OY ON OY (bone loss) /-JPfCliDI Ii PPCliOz.. " fPCliD3 t-t P peuD,/ 4-rJ.revent cardiovascular disease ON OY ON OY ON OY ON OY 1+1" ((, PD I HPRIPPz.. j-If~/JD3 H fR./ I'D,! tl. regulate irregular period ON OY ON OY ON OY ON OY I-iPTPFDI 11PrPfoz. I-fPTf'f03 I-i P T?Po'I 6, treat painful periods ON OY ON OY ON OY ON OY HPBLPOI HPBLPD2 HfBLPI?3 I-iP8LPp+ 7. bring on late period ON OY ON OY ON OY ON OY tft:P/~R 8. prevent a miscarriage I rftlPtili' 2. m; f''6'P ,sJ/'P,tjlj' 't t'NPMt~1 IHH"pz.. d~P'-6V'f 9. As a morning after pill ON OY dif'15'P dt/Tf;~6Z. tfF~"Y6~ ):I.f T rR6 '-I 10, To test for pregnancy t!,fTb''t' ljPT£iJP2.. (,iP TE:>JD .3 'ff'hlfiJt, 't 11. To treat endometriosis tJlJTMDI ON OY I.iTO~ f+PT1JuP"' ~~{J~fr 'd-}:jro9/" 12. To treat ovarian problems id Vi ON OY ON OY cfi,f fTOv~ 2.. ;/hOD:>3 tiP TtJP-,> 'f 13. to treat another disease '6TITgty' I ON QY t!;~a ~ tfPO&'i.. 9./l>ov'3 N6'tJl I'-Iumber Now I would like to ask you about your menstrual history. 11. How old ware you when you had your first period? [I] AC3ErMP ege (years) CODE FMP AND CIRCLE AGE OF FMP ON CALENDAR 12. During your 205 and 305 (when you arelwere not using birth control pills) arelwere you usually able to predict ON when your periods would start within 2-3 days? OY 13. (Ask only ofwomen age 40 and over) Alter age 40, 0= ONo rOLEt>JUN(.. did your cycle length evar become highly unpredictable? That is, sometimes very short (e.g. less than 25 days) I :: 0 Yes and sometimes very long (e.g. more than 40 days)? - 2. -:- 0 Prior surgery _ ; '" 0 Don't Know _ /.. ~ 0 Under 40 yrs old ffyes: 13.1 At what age did this start to happen [I] age (years) - - • Page 36 of 72 • ------_. .E:!I] SECTION J MEDICAL HISTORY 37430 • f I am going to ask you some general questions related to your medical history before "REF MO YR*. J1. When did you most recently have a routine 0-:: 0 Never gynecologic checkup before ·REF MO YR", if ever? \ ~ 0 Within 1 year before 1. ~ 0 Within 2 years before 3 :: 0 Within 3 years before 't~ 0 Within 5 years before ? ~ 0 5 or more years before _ 3 ~ 0 Don't know J2. Before "REF MO YR", did a doctor or health Howald were you professional ever tell you that you had any of when was the following diseases or conditions? diagnosed? Age at Diagnosis a. Thyroid problem CD PTTtI'f p,,,,€. If had a thyroid problem, was it: 0::;:: 0 Overactive I ~ o Underactive ;, ~ 0 Other (sp) -:3"" 0 Don't know b. Cancer ON OY If had cancer, what type was it: Age at Diagnosis Cervix ON OY PTc.E\z'\l<.A CD A6€Gr>.JLA Colon or rectum ON OY PTc.(..NLA CD A6EC.l-N<.A Uterus or endometrium ON o Y PTUTE"i<.c.... CD 'V;,E U T c.f' Non-melanoma skin ON OY PTSKI>.J(.A CD A6ESKf'JU' Lung ON o Y --p-r L tJ ....LA CD Ac;,E: (..,Jt. (.A Melanoma ON OY PTHEl-AN CD 1'6.£ ME.\""" Breast ON o y PT BICSTLA CD A€>E e,RsLA Other (sp) ON OY ~TOTtlc.A CD A 6.£ OT tI c.1'. Don't know ON o Y PTL,,·J "- (. '" CD AGEUNl'.c.A • ~ • 37430 • Age at Diagnosis c. Ovarian cysts ON OY PiO\l(.,p' OJ A6.r:;OW:.yS d. Fibroid tumors (uterine) ON o y PTf II!>I!.TM OJ AbE f' I \3T M e. Gonorrflea (clap) oy (?Th"",' ON OJ ""6.6''" c.. f. Chlamydia ON o y Pi ~>,<:. T OJ AbE:. c.T g. Trichomoniasis (trich) ON o Y hTf<.''-'' OJ AGE ,1/..,<:'>1 h. Bacterial vaginosis (SV) or gardnerella ON OY Qill"e.'1 OJ Ab81>" i, Pelvic inflammatory disease (PIO) or !".bE. VIP pelvic infection not related to surgery ON OY \ll"H""'O OJ j. Polycystic ovaries or (peaS) or Stein ON OY ~IPC.OS A6f:. ?c..oS Leventhal Syndrome OJ k. Lupus or SLE ON o Y (JTLLJ PUS OJ A~E.l-.0PLl~ I. Arthritis ON o Y 9,1\1/..\ II ~ OJ A6.eA-L't'<~ If yes, was it: o Rheumatoid Arthritis o Osteoarthrilis rT/'I1Z-IT'f o Dont' Know m. Asthma ON o Y \!Tf\':>'ThNlA OJ A bE. AS'T It i'"\ n. Atopy or chronic allergies ON OY PT/I.TOI''! OJ A<:.E. ATDfy o. Gum (periodontal) disease ON OY fTC,U!'\17;, OJ A 6-E.",u "'11)S p. Infectious mononucleosis (mono) ON OY I'TMO,..lo OJ Ao.E MONO q. Chronic fatigue syndrome (CFS) ON OY (J,(.rS OJ A6"CI'S r. Hypertension, high blood pressure ON o Y hrl'1 p~\C.. OJ AG.E.I1'-/ fR. s. Diabetes (sugar) ON OY PiOl/"TBfl OJ A G.e'Dlr-B If yes, Did you take insulin? ON OY rT, NSLJL Did you take an oral medication to lower blood sugar? ON OY r'lORAL. 06 • Page 38 of 72 • -.._- .E:!I] 37430 • ,- How old were you when diagnosed? J3. Did you ever have endometriosis? ON OY l'TEt-'OON J3.1 If yes to endometriosis: Prior to -REF MO YR· was your endometriosis treated with ,,(SHOW CARD) 0, Hysterectomy \?,-fti"~ON OY o DK 1. Other surgery (sp) PTO"~-:>(("" ON OY o DK For how long (years)? Have you 2, Birth control pills ENOO&'P ON OY OD'hJ>i~rn told rne about th',s use for PTL0PKot-l Oy 3, Lupron ON ODK rn endometri I-U ~"",,,, '/1<\ QSIS already? 4.Danazol OfHJf'l1-OL ON OY ODK rn DANf\7.L'i~ IF YES, 'ode 5. Goserlin or Synarel e::"o';,E"" L 1.-.) ON OY ODK (years) as ""0:£i'-'I II-. rn -2 6. Bromocriptine or Parlodil 01lO \-\0 c-VJ? ON OY ODK - BQOl-IO'/11.S rn 7, Clomid (other than already mentioned)G.DN I)ElJO 0 N OY ODK rn c.LH0 EN'{I'-. 8 Any other medication(sp) OI-JEDEI-JDO ON OY ODK 01--1 EDEN '{ R, rn 9, Progesterone only medication PRo" ENOO ON OY ODK rn Pi • Page 39 of 72 • • E!ll 37430 • ,-J4, Prior to "REF MO YR' did you ever take any of these medications for Jt least six months for reasons other than endometriosis? Please tell me about medications you 010 NOT mention earlier. (SHOW CARD) For what reason? How long? (SHOW CARD) 0: 0 Fibroids L- uP I': R~N a. Lupron ON OY L-U P"O-r11 \ .,. 0 Chronic pelvic pain L ~ 0 Uterine Bleeding :J ~ 0 Fibrocystic breast disease '-f ~ 0 Other (sp) o -= 0 Fibroids b.Danazol ON OY rn DI'lN 2OT~ Of\>JZOYR I'" 0 Chronic pelvic pain 2-: 0 Uterine Bleeding 3; 0 Fibrocystic breast disease '-I,OOther(sp) c. Goser1in or Synarel 0 N 0 Y o : 0 Fibroids 60::,E« R> IJ G-DS E:il.OTJ-\ J ~ 0 Chronic pelvic pain z: 0 Uterine Bleeding 3,:- 0 Fibrocystic breast disease 'f, 0 Other (sp) d. Bromocriptine or ParlodiJ ON OY 0-, 0 Fibroids B R0 t-1 0 R StJ BRONoDTrl rn 13f10fYoyP-, ('<:' 0 Chronic pelvic pain 2..= 0 Uterine Bleeding 3-== 0 Fibrocystic breast disease tf= 0 Other (sp) 0.0 Fibroids LLOt-fDR..S,J e. Clomid ON OY Gi-OHDOTJ! I.". 0 Chronic pelvic pain l. 0 Uterine Bleeding .3.: 0 Fibrocystic breast disease - 4· 0 Other (sp) • Page 40 of 72 • .E:!j] SECTION K HEIGHT, WEIGHT & GROWTH 37430 • Now I have some questions about your height, weight, and growth "1. Let's start with your height and weight. How tall are you? rn rn feet inches tuFf riG, T /NC-H cJ "'" 0 Around the chest & shoulders K2. When you gain weight, where do you tend to put it on? (SHOW CARD) I==-O Around the waist & abdomen Z- '::" 0 Around the hips & thighs 3. o Equally all over ;JbTlJtiERE 'f. 0 Other area (sp) K3. Not counting after pregnancy \ how many times since 0: 0 Never you were 18 have you lost as much as 10 pounds or 1::= 01-4 times more and then later gained it back? (SKOW CARD) Z = 05-9 times ;'.:: 010-14 times 4 = 015-19 times !5.,... 0 20 or more times K4. How much shorter or taller would you say you were in comparison to other girls your age, based on the following - ",tegories? (SHOW CARD) a. Ages 9-10 years (4th or 5th grades) 0: 0 Much shorter I ~ 0 Somewhat shorter L -= 0 About the same 3 =- 0 Somewhat taller tf= 0 Much taller b. Ages 12-13 years (7th or 8th grades) 19:: 0 Much shorter I • 0 Somewhat shorter TA LLIZ 'fK 2:;: 0 About the same 3; 0 Somewhat taller l.f= 0 Much taller c. Ages 15-16 years (10th or 11 th grades) 0= 0 Much shorter '0 0 Somewhat shorter Tf'l L LIS Y R.. z = 0 About the same 3;: 0 Somewhat taller 'I' 0 Much taller • Page 41 0172 • .E!jl 37430 • ••..J. How much did you weigh when you were 18? (Probe for non-pregnant weight) ITO uJG HT IE, K6. How tall were you when you were 18? ITJ ITJ f99f inches Hr=oTFT/8 K7. How much did you weigh when you were 3D? (Probe for non-pregnant weight) ITJJ IV Eo NT 30 K8. What was your tallest adult height? ITJ ITJ "'./ inches - H(,TPTAD H6T/NAD Kg. How much did you weigh when you were 50? (Probe for non-pregnant weight) ITJJ War/TEO -2 if less than 50 yrs old K10. What was your weight at >REF MO YR>? ITJJ 1IJ6HTfUF • Page 42 of 72 • ------_._-- .~ SECTION L: 29900 PRESCRIBED AND OVER-THE-COUNTER MEDICATIONS • l[).'..l',mber TONUM I would now like to ask you about your use of prescription medications other than the female hormones that we have already discussed. I would like to ask you about medications you may have taken for pain or inflammation. Conditions that are treated with these medications include arthritis; menstrual cramps; headaches; injuries like sprains, pulled muscles, or fractures; minor sugery or dental procedure; or back pain. We are interested in any of these medications you have taken regularly for at least 6 months. Regularly means at least two tablets per week. L1. Prior to _ _ 1_ _ *REF MO YR"', have you ever used ON (g%L2) A':> PIK,N aspirin at least two tablets per week continuously for a period of 6 months or longer? OY 1 3 4 A5PRtJNM\ ASPRNNN3 l\~pel-{iJM't l1.1. What was the name ITIJ of the aspirin? (SHOW CARD) ITIJ DIJ A::'fR>JD~1 lJDo.2. l1.2. What was the dose? OJ ffi rnD5'f Pes PDo,TfVJ I t'tSPD:>TM l. flsPiX,T1-13 f\!,j'DS TN't cJ;:" 0 Per day o Per day o Per day o Per day I" 0 Per week o Per week o Per week o Per week 2..:;;: 0 Per month o Per month o Per month o Per month L1.3.. Did you take upirin for ttte rollo~ng conditions: (SHOW CAROl Arthritis bursltls I1)Pft{{Tt+/ A"5PftfZT}f2. , . ON OY ON OY rheumatism A SfG.UUTI )T;'P6auT2.. Gout ON OY ON OY A-~ pGI2.I.;P I Its f'CIU'< pz.. Menstrual cramps 0 N 0 YON 0 Y !tSPINJ J A->p,,.;::r2 InjUry ON OY ON OY A5PPE~TI A~PD£>JT2. Surgical/dental paIn ON OY ON OY I\:>P 0A~<-1 Ao,P 0I\G"-z. Back pain 'ON OY ON OY ASPltEftD, I'>~PrlEftDz.. Headal:he ON OY ON OY !'I;' PMoS>-'-1 f\:,p "'IJ""-z.. Muscle Ache ON OY ON OY A-s l'6 TIt, A 50 PCn"-"H L Other(sp): DN OY ON OY Don't know o N 0 YI\$PtJlJK.1 0 N 0 Y A~P"j,J,-z. WIl.A6E z... L1.4. At what age did you AWG.£' start taking aspirin? P.~ rr....·~ErJ r ASPf2...J.e.JJ 2 L1.5.0verall, tor how long did yoU take aspirin? OJ OJ {.l:: 0 months 0 months A 5- (J J..l.JT}-A I J"tS PL,.J TM z.. /.. 0 years 0 years • Page 43 of 72 (Mark ASPIRIN on calendar) • _.. _...... _ .~ 29900 • l-':lnor to _ _ 1_ _ *REF MO YR*, have you ever used an o~ _. -the-eounter pain or inflammation reliever other than aspirin ON (go to L3) at least two tablets per week continuously for a period of 6 months OY or longer? 1 2 3 QTc l'1<,rJ /VI I Ole.?iI.>.JM 2- Olc.rl"-N H:, l2.1. What was the name or the over-the-counter [ill [ill [ill pain reliever (SHOW CODE CODE CODE CODE CARD) OTe. YO;' I vS OTaD~3> OTc.P D~'+ 2.- L2.2. What was the dose? OJ rn OJ OJ o -rc.I7;'TIVI \ OTC.IY.:>TN L.- OTe.0,1i-1"3> OTc..D~TM4 o Per day o Per day o Per day o Per day o Per week o Per week o Per week o Per week o Per month o Per month o Per month o Per month l2.3. Old you take aTe pain reliever for the followlng conditions: (SHOW CARD) OTc:.A/...T~"2 Arthritis bursitis O,c.AIZ..'lr', \ oTCAl2.T,I'" rheuma~sm' 0 N 0 Y ON OY ON OY o TC...G.our I OTI.."""", " OTL6,C5L'I1" 3 Gout ON OY ON OY ON OY OTCCJZHf , OTLc..~n '?z... p -..truat cramps ON OY ON OY G';rc.c§,r ?> o TL I ",;:r I OTCl,.J:JZ. OTc.l N:J" Injury ON OY ON OY ON OY c::rfC "D e.1'JTI OTLDENT2 O'LDEt-.lT" SurgIcal/dental pain ON OY ON OY ON OY C)1c.."BAc'"I OT(. BAG"-"2 OTC Bk."-3 Back pain ON OY ON OY ON OY OICtlEADI o TC 'TEI'IO " o Tc. H EJ'D ;!, Headache ON OY ON OY ON OY grre..t;)i~~ oTU..l/.J:>C Dl o TC-J.1 '-'SC3 Muscle Ache I ON OY ON OY OTCOTH/ OTC-OTH2.. CYTc.oTH3 Other(sp): N ON OY 2J -rr3:YK/ OJ-,2bh. I') 7C-DJ<.3 Don't know ON OY ON OY ON OY PIl-6E", L2.4. At what age did you W LL(A (Mark OTe pain reliever use on calendar) • Page 44 of72 • .~ 29900 • J.2. Now looking at the card, have you taken any of these o N (go to section M) scription medications for pain or inflammation regularly for at OY r:<><.PAIN least 6 months? L3.1. What was Ule name of the prescription pain [[[] reliever? (SHOW CARD) CODE CODE ~rn\ R;<.PR~L L3.2. What was the dose? IT] ""~PD""TM \ R>< "V~Tt'\ z- \2." f' D5>TI-I 0- \'-)( FI)~TM't o Per day o Per day o Per day o Per day o Per week o Per week o Per week o Per week o Per month o Per month o Per month o Per month LJ.J.. Did you take prescription pain reliever tor the following conditions: (SHOW CARDj ~ t'~ ~t\ \>X? "~'~Z R""A"-'~o, R><.;>.A~'~'1 Arthritis,. bursitis, r'6 \ ON OY ON OY ON OY rheumatism RBf 60JT I Rx.. t" G.ouT 2. ~ F' 6Llu1 "'30 1<.><. ~6C>JC"I Gout 0 Y ON OY ON OY ON OY l' 6.12-"'~ I R><.PC.~f Z f'.><."C"-N~3 g.~I~'?~ )I1!!nstrual cramps 0 N 0 Y ON OY ON OY ~l' I ,,;:n R><.I'\N:rL R..)(,.? 1\'''.) ~ ~ Rxf Ir-JJ't II.Jury ON OY ON OY ON OY ON OY R.x POc:tJT, \<-l<-PDE"'T Z- \ The next question is about use of talc powder. M1. As an adult and prior to ·REF MO YR· did you ever use talc or baby powder or deoderizing powder with talc at least once a month for 6 months or more in any of the following ways: (SHOW CARD) How long did you use it? O. On your feet, arms, or breast, but not to 0 N genital or rectal areas? IALL f\P.::!'-- 0 Y # months OR # years 1. As a dusting powder or deoderizing spray 0 N ~EU1~[[] ~ to your genital or rectal areas? TA LC. bEr-J 0 Y [[]iSE"} GErJ'i-.&..'{ # months OR # years 2. On your sanitary napkin? ON [[]=t\"IJ~rH,l[[]5A>JNflP'I ~ OY # months OR # years 3. On your underwear? ON [[]U~O'tJ~H,J [[]L);.IDvJl<. 'fK. OY # months OR # years 4. On your diaphragm or cervical cap? TALLP'A~ 0 N [[]DII\P~H>J[[]PIA Ptly R.. OY # months OR # years M2. Prior to 'REF MO YR' did your partner ON ever use talc or baby powder or deoderizing OY [[] [[] powder with talc at least once a month for 6 months or more? pPI '/..T TALC # months OR # years ?PtQ.TN~N0 Ff'\~TrJR..,/ R.. If yes to any above: M3a. During the time when YOU were using ON any pOWder, did you specifically use a formula OY [[] [[] made with cornstarch instead of talc? \/fLo R.tJ ";>\ ODK # months OR # years O n/a PTUN Nt-.l P,LIZ->J Yt< M3b. During the time when YOUR PARTNER ON was using any pOWder, did your partner OY [[] [[] specifically use a formula made with cornstarch - ODK # months OR # years instead of talc? \' >J CD IZ-l-l S/ On/a \'N~KN Pl-\ i.RN'/ R... • Page 46 of 72 -.-~--_. • ... ---- ~ SECTION N SMOKING • 33837 • The following questions are about cigarette smoking N1. Have you ever lived in a household with people who ON smoked tobacco in the house every day for 6 months or more? OY Jfyes: N1.1 How many years were you living with smokers? [[J Number ofyears N2. Have you ever smoked cigarettes daily for 6 o N (go to Section 0) months or more? OY (7TSt-IO(,E N3. At what age did you start smoking daily? [[J AbE~TSMI'-. [AGE 1] N4. Were you smoking daily on ·REF MO YR- ? If yes, ON code AGE 2 as age at "REF MO YR·. OY N5. At what age did you finally quit for good? [[J [AGE 2] N6. (If difference between AGE1 and AGE2 is one ON year or greater) Was there ever a period of one year OY or more when you qUit smoking? If yes: ~ N6.1 How many years between [AGE1] and [AGE2] did [[J 'j JJ D Sr<\ ¥-.. you not smoke daily? Number ofyears N7. During periods when you smoked daily, how many cigarettes a day did you usually smoke on average? [[J (One package contains 20 cigarettes) Number ofcigarettes • Page 47 of 72 • .~ SECTION 0 ALCOHOL HISTORY 33837 • The following questions ask about alcoholic beverages. If the answer to question 1 is NO for ALL beverages, go to section P. Beer Wine Hard Liquor (12 oz can) (4 oz glass) (1,5 oz shot) 'BE-tOt.. WI.v~ I~FlWUGl. 01. Did you ever drink ON co No ON on a regular basis--at least once ,! 0 Yes, red wine only a week for 6 months or more? OY OY ;, 0 Yes, white wine only .; 0 Yes, both red and white wine 1'\6£."1:'.10i<.. AbE:,.J,rJE AbEl-IQ.u 02. How old were you when you started drinking on at least a weekly basis? ITJ ITJ ITJ age age age 03. Were you drinking GEU.U:I' WI>JE:«.E:\" LlGlLlIZEF at least weekly at ·REF MO YR· ON ON ON .- If yes, code AGE2 as age at * REF MO YR" and go to 05. OY OY OY Plb,,-w,>JE:. "L- A bE. L.\ C>LJ l. 04. How old were you when "'bE \?E. Ei1.L you last drank on at least a weekly basis? ITJ ITJ ITJ age2 age2 age2 ~E:E.'R}\ W ".jE: A1"\T 1..1 GlLJAMT 05. When you drank 1-\, regularly, how much did you drink per week on average? ITJ ITJ ITJ CanSl80ttles Glasses Shots • Page 48 of 72 ...... • _ _._------ .~ SECTION P ACNE AND UNWANTED HAIR 33837 • Th~ next questions are about acne and unwanted hair, such as hair that grows in a male pattern. While a lot of ,nen might have bouts of acne or darker facial hair, these questions should be answered only jf you feel your acne or facial hair needed treatment--either through over the counter remedies or prescription medication. P1. Were you troubled by acne during your teen years? ON OY If yes: P1.1 For how long (in years)? [[] years P1.2. Where was the acne located? (SHOW CARD) O. Face ON OY F P 2. Shoulder ON OY 5 \'\O<.!TEEt-l 3. Back ON OY GAC"-'EE,.... 4 Chest ON OY C-\-\~TEEN 5. Other (specify) - ON OY O,\\T£\::I-l P2. Were you troubled by acne efteryour teen years? ON ACNE Ave-T OY ifyes: P2.1 For how long (in years)? [[] '1 RAuJt.Ai) years P2.2. Where was the acne located? (SHOW CARD) O. Face ON OY Fflc..E"Ow 1. Head ON OY 1-\ E!\v fI D l..'I 2. Shoulder ON OY 5 he\! I've-"" 3. Back ON OY 1? f'C,,- f\ D l-T 4. Chest ON OY C-..'t\~l A'DL-I 5. Other (specify) ON OY 0,\\ f\ v e-T - • Page 49 of 72 • .E:;Jj 33837 • ON ,""'3. Did you have acne as of *REF MO YR*? OY If yes: P3.1. Where was the acne located? (SHOW CARD) a Face ON OY F "'<.-.Eo \2.E F 1 Head ON OY rtE'f\D I2.£F 2. Shoulder ON OY S \-IOu Il£r 3. Back ON OY I:> f'U- \?E " 4. Chest ON OY c.. \,<:;"~ F 5. Other (specify) ON OY OT~ u;: I'"'D ON P4.Have you ever been troubled by unwanted hair? OY Ifyes: P4.1. Where was the unwanted hair" (SHOW CARD) O. Upper lip ON OY L\pt\Pnt.... 1. Neck ON OY N t:c"->lF\ \I'-. 2. Chin ON OY C- \\ l>-l "F\\I'-. 3. Chest ON OY C. \>::>"1 \-\ 1'1 \ ~ 4. Stomach ON OY :'>III\<\ '"f' \ h 5. Thighs or Legs ON OY "\\-\\6>\1'\''' 6. Other (specify) ON OY O"T \'I \-\ P\lV o Right P5. What hand do you usually write with? o Left Prft IJ D we.." T o Both - • Page 50 of 72 • ~ SECTION Q • 33837 SUNLIGHT EXPOSURE & ABSORBTION QUESTIONS • Now I will ask you about how much time you spent in the sun during various times In your life In the past 5 yrs As a teenager 01. On the average, how 0<1 hour 0<1 hour many hours per day did you o :>=1 to 2 hours o :>=1 to 2 hours spend in the sun during the summer months? (SHOW o :>=2 to 4 hours o :>=2 to 4 hours CARD) 0>= 4 hours 5lJtJ~tlI? 0:>= 4 hours o Don't Know o Don't Know 02. During the summer, how o Always/Often o Always/Often often did you use full sun 5lJtJ~(R,? Sometimes 'SU0~\1--J protection, including sun o Sometimes o screens (spf 15 or higher) or o Rarely/Never o Rarely/Never clothing? o Don't Know o Don't Know 03. On the average, how 0<1 hour 0<1 hour many hours per day did you o >=1 to 2 hours o :>=1 to 2 hours spend in the sun during the o >=2 to 4 hours o >=2 to 4 hours winter months? (SHOW SUtJII-.h t-JTt'-l CARD) 0>= 4 hours 5l1J tJ ,oJ'? 0:>= 4 hours o Don't Know o Don't Know Q4. During the winter, how o Always/Often o Always/Often often did you use full sun o Sometimes 5U~5(Jl.w'b o Sometimes protection, including sun 5JoJ:;u,JTN screens (spf 15 or higher) or o Rarely/Never o Rarely/Never clothing? o Don't Know o Don't Know QS. Suppose you were wealing o Get a severe sunburn with blistering no sunscreen lotion and your skin o Have a painful sunburn for a few days followed by peeling were exposed to strong sunlight for the first time in the summer for o Get mildly burned followed by some degree of tanning one hour Would you... (SHOW o Get brown without any sunburn CARD) o Other (specify) SUN Gu RJ o Don't Know • Page 51 of 72 • ---_._-- .~ 33837 • A.61n which states or foreign countries have you lived? (If a woman lived in the same state ore than once, record each occurrence separately). (For birthplace, code first age as 00) State/Country (Abbreviation) Code Age when moved there Age when last lived there a. ITJJ STf\"lE\ [[] AbE.t-\-J'.;T\ [[] AbE LL-ST \ b. ITJJ ::>TffiE.Z. [[] hb<::l'-\-l5,L [[] Abc.LLSTL. c. ITJJSTflTE." [[] Abt.!,,\V?T~ OJ f<61€ Ll-:;':; d. ITJJ'5Tf\-,c1\ [[] A.6-E 1'\0:>,'"" OJ AbEL-LST'! e. ITJJ STf\TE.S> [[] AG>E:l-IV>IS [[] A6ELl-:'>T5 f. ITJJ -=-TPii"E.0 [[] AbENl0:;,TI<> [[] A6.E LL"" 1.0 --g. ITJJSrflTEl [[] ""6E.1'I\>J"'1 ITJ 1\&1;;LL>11 h. ITJJ ~TflTEf3 [[] AbEM~~TB OJ A6c,LL::,T8 i. ITJJSffi1B1 [[] AGEMv.s19 OJ A6El-L.519 j. ITJJ5T~lb [[] Ab.EI'I\'.J~IO [[] A6'C:l-L- '" I 0 ITJJ 3\f1i'E: \\ [[] AbEl"\u ~ \ I [[] ADeLL-SII I. ITJJS1f\Th.1Z- [[] AbE. 1"\ v ~\ L [[] AE:,EL.L.SIL m. ITJJ~5 [[]Abe.M'.J~T"~ [[] A6E L.L.S I 3 n. ITJ A6EL.LS,4 • Page 52 0172 • • SECTION R: PHYSICAL ACTIVITY • 10 Number L I I I I I I I I J I DNUr"'\ o N (Go to Section S) R1. Here is a list of activities (SHOW CARD). Did you ever engage in any of them at fH,!> i~cT least once a week for 6 or more months in a row? OY Leisure Activity(s) 12-18 yr (7 yrs total) 19-34 yr (15 yrs total) 35-49 yr (15 yrs total) >50 yr ( yrs total) Activity Name Code No. yr mostyr hlwk Code No. yr mostyr hrtwk Code No. yr mostyr hrlwk Code No. yr mostyr hrtwk AUJrLrnirn rn :"fffrn"[]j'toIrn'tIJ ITffjjfcEfEo rn rn~S-O l 2 I'Gc.t:i""rn rn rn' rn rn rn rn Irn rn rn rnrn rn rn rn 3 I~rtrnrnrn rn rn rn rn'rn rn rn rnlrn rn rn rn j\-Lnv'-t12 4. W rnrnrn rn rn rn rn rn rn rn rnrn rn lJJ rn 5. wrnrnrnrnrnrnrnrnrnrnrnrnrnrnrn f'-"CI":l...l L.-.. Iz 6 rn rnrnrn rn rn rn rn,rn rn rn rnrn rn rn rn /'i--nJ712 7 .CO rnrnrn rn rn rn rn rn rn rn rnrn rn rn rn 8. I 9. A-a1wrnrnrn I rn rn rn rn Irn rn rn rn1rn rn rn rn if r.! <:! 0;- i '!" \l\ \l) \1\ o:r, ~ )- 2~ ~ of L ti U1,()", rf\ 0"'"2 oi t:r 2: (j a-- 't to ol '2 eJ lfl cl. I r ':i cr- lJ""" -:'l 7":-- .... a- (J "r ..... t .,. cr l-::k ,-:: 0- ~ I? cr" iJ_ c:r \ ¢.;.;:....J 'J t- 4:; 0 -I- cr~?U \- ~ 81. Let's start with your mother. Did your natural mother (the woman who gave birth to you) ever have anyone of the following cancers? (SHOW CARD) Age at Diagnosis ('/\l'\\bIl€M-r o. Breast ON OY ODK IT] '" A: ~I2..A..E. 1. Ovary ('<\'"D" f<"-)' ON OY ODK IT] rf\flO" .... P,"'E ffifTf'-fJ DO 2. Endometrial ON OY ODK IT] r<\"'E. N 0 f'lb.E I"ITCE9..-J 3. Cervical ON OY ODK IT] fi\'"L" f'\'"IS f'\ ",-r>1i R- 4. Thyroid ON OY ODK IT] M Pc T\-\-'i f't; C:tlE m f-\L6l..D,.l 5. Colon,rectum, bowel, ON OY ODK rY\ A LOL f\&E. intestine IT] 6. Skin cancer (non ON OY ODK IT] IV\ f\:>\(.N l'I6.E. [1'\ l\~l'.\ fJ LA melanoma) f'l\f'tt-lE.l.f\tJO 7. Skin Melanoma ON OY ODK IT] '" f>< M6 L- ",...E. - \l.\l\ull EO"... 6. Liver ON OY ODK IT] fV\Pr l-\ V A6.E. foJIf> {'I\f\0Q.f\IN10. Brain ON OY ODK IT] fY\ l'I ~"-N A6.E M flW,.l£ 11. Bone ON OY ODK IT] MR P->N £ "'''''E MI'I';>"I0N-L\\ 12. Stomach ON OY ODK IT] MA ",TM AoE. Mf'1LE.Ll~'CtJ\13. Blood/leukemia ON OY ODK IT] M A; LE.U Ptc=..E. MAf!>Lfl091l14. Bladder ON OY ODK IT] M f\1:>1...f\ f\"'~ MAL-'/M rt1 15. Lymphoma ON OY ODK IT] II< I't Lyrn (-I6.E: Mfl I-IDD6.\<" 16. Hodgkins ON OY ODK IT] /III !=\ 1-\6. '- A6.€ MAl.J DNE)' 17. Kidney ON OY ODK IT] Mit KD)' Ao.E MA: PA,JaE.18. Pancreas ON OY ODK IT] M ",oN c."'GoE .- M AOf./AL 19. Mouth{oral) ON OY ODK IT] !VI Fl 0 R..L- f'ro. EO MA-DntLA 20. other (op) ON OY ODK IT] MADCAA-6E • Page 54 01 72 ,-~-_... --- . • ._------.-.__ .~ 46219 • Age at Diagnosis ·-2. Did your nalural mother (the woman who gave MAP~OD "'rlh to you) ever have polycystic ovary disease? ON oy ODK rn MA pooA".e, ;V1A DES S3. Did your mother use DES (diethylstilbestrol) ON oy ODK when she was pregnant with you? 54. Let's move on to your father. Did your natural father ever have anyone of the following cancers? (SHOW CARD) Age at Diagnosis O. Prostate ON OY ODK rn F \' Ie:'>T A be. 1. Thyroid FATf\'i"- ON OY ODK rn FA"\ M-"f f"t 6E... FACOLDt-..) 2. Colon, rectum, bowel, intestine ON OY ODK rn FI't'-L-N f'\6E. 3. Testicles FATES>T1C ON OY ODK rn FAT:>TA"'E. 4. Breast FA BI<..E/'IST ON OY ODK rn FAB",'-Ac.E 5. Skin cancer (non melanoma) FA5K.rl.kA 0 N OY ODK rn FA"'''-N A"'E 6. Skin Melanoma 'FAMcL../'>t.NO 0 N OY ODK rn FA HE.L-f\C'>.E. 7. Liver \- PI LI\l EK. ON OY ODK rn FAL.I....rF'lbl2. l. Lung PflLUN"" ON OY ODK rn FA L-N b. Ac.S 9. Brain P f\BRA r N ON OY ODK rn I'"A BI'-.'" A c. € 10 Bone Ff'lI2>ONt. ON OY ODK rn P PI GNE. AC:>.E: 11. Stomach FA":iiDtJ\c..l-I 0 N OY ODK rn I'"A ':>TM PI "'< 12. Blood/leukemia FALeu...€ Iv\ 0 N OY ODK rn FAL-u,,-AGoB 13. Bladder F PI BL.-f'I DDI<-. 0 N OY ODK rn F PI ~L.-f\ A""E. 14. Lymphoma FFlL'i M~" 0 N OY ODK rn FPlL'I M AE.E 15. Hodgkins FPt rlODG,\<-. 0 N OY ODK rn FPI >-\"'\'-. A&£. 16.Kidney FPI\'...\QNEy ON OY ODK rn FA'l--IQAE>\O. 17. Pancreas F PAN c..!Z..E:A 0 N OY ODK rn FAPt--lc..AbE 18. Mouth(oral) F ROKf-'I L-. 0 N OY ODK rn FA O!Z..LAG.€ _19. Other (sp) FPtOTi+ cA 0 N OY ODK rn FAOCJ"G.E: S5. Did your father develop early baldness before age 30? 0 N 0 Y 0 DK 0 NA FF\C>FlLO • Page 55 0172 • .~ 33414 • ID-"" Imber Now let's move on to your sisters. 56. How many sisters do you have? Count only those sisters related by blood (full or half sisters, but not step sisters or adopted sisters. Number ofsisters Ifparticipant has any blood-related sisters." 56.1 Did any of your blood sisters have a diagnosis of polycystic ovary ON syndrome? OY 56.2 How many of your blood sisters were diagnosed with polycystic N M pea :';,\'S ovary syndrome? (code 00 if none) IT] Number ofsisters 56.3 Did any of your blood sisters have a diagnosis of cancer? ON OY S6.4 How many of your blood sisters were diagnosed with cancer? .Jcode 00 if none and skip to question S8) IT] Number of sisters 56.5 Did any of your blood sisler(s) ever have the following of cancers? (SHOW CARD) - • Page 56 0172 • ..--._----_._...~ • r:JJ 33414 • B..emember we are talking about your blood sisters~-Ful1 sisters or half sisters (same ,ther or father) SISTER 1 SISTER 2 SISTERJ TYPE OF CANCER: Age at Diagnosis Age at Diagnosis S"I IeQ.",-r rn ~,c>~f">& 5:tZ.e,evT rn Breast ON OY OOK "ON OY OOK SIOvA"-i rn~ID,f\L'",L .. 5V::N"'''-'' rn Ovary ON OY OOK pl!>YN OY OOK S \ ENOOM _. f.) - -"....)"....-...... "".....- ~z~ -~'. rn Endometrial ON OY OOK rn tON OY OOK ';0. c.EI1.~ rn~O"pI>- 5u.£l'-O rn Cervical o N 0 Y 0 OK ~. p«.O N 0 Y 0 OK 5IT~~O'O rn~I~~~ "z-T~iW rn Thyroid ON OY OOK ,.p0N OY OOK Colon, rectum, 5 I C.OLOr--l rn ~ 5:z.L.DL.D~ rn bowel, intestine ON OY OOK ~," ~"ON OY OOK S\5~IN ill~":~ t7\5 lLltJ rn Skin O N 0 Y OOK \' ...... bO N OY OOK non-melanoma <;; I '"a.A"; ill~,r 5lJv\E.L.P\N rn Melanoma o N 0 Y 0 OK ,C' 15"-.,I- 0 N 0 Y 0 OK O~lL~VyE~ODK g~u~~ Liver 0\,)/ON rn 51 LU""'" rn~"';>'b ~Z-u.JN'" ON OY OOK il"","ON OY OOK rn '51 e,f/.l'\".1 rn/').J- 5Z-00'''.I rn Brain o N 0 Y 0 OK ","'1'" 0 N 0 Y 0 OK 5' l.!>Ot-lE r-Tl.,,1!> ~ 52.~t--lE rn Bone ON OY OOK LLY t"~ON OY OOK 51 :;TDM rn " Sz-~17)""" rn Stomach o N 0 Y 0 OK '" ~'" 0 N 0 Y 0 OK Bloodl 5 I b.EUKEM ~v~ 5Z.L.~LJt::..e:f1rn leukemia ON OY OOK LLY ""bON OY OOK SI !3L.ADD"'- rn-"ODI<.. rn Bladder o N 0 Y 0 OK ~'I"" 0 N 0 Y 0 OK 51 L.Y,·WH 5LL-YI'1PH Lymphoma o N 0 Y 0 OK rn'>'''-'' ,f'''' 0 N 0 Y 0 OK rn S"-+CO,,Kt--l rn"/" 52.ItOo<>KJJ Hodgkins ON OY OOK btON OY OOK rn ~ 5IK'O>J"'1 +-,0 52..tl-.JO>Je;y Kidney ON OY OOK D' cJ-0N OY OOK rn ~~ 5' PI'> "'C "- S -"Q~ :52. pp, >J c.Q.s rn Pancreas ON OY OOK rn --,~ON OY OOK ~gA' 5/0",,-1"<,..,....ooY" ::J20QA L ON OY OOK Mouth(oral) ON OY OOK LLJ' ~ ON OY OOK rn =:>THeA SIOTHCA 52.DTrtc.A , r(sp) ON OY OOK rn"'rY-, ON OY OOK rn ON OY OOK • Page 57 of 72 • . _------_._---- ~ • 33414 • - Now let's move on to your brothers. S8. How many brothers do you have? Count only those brothers related by blood (full or half brothers, but not step brothers or adopted brothers Number of brolhers If participant has any blood-related brothers ON S8.1 Did any of your blood brothers have early onset baldness (before OY the age of 3D)? oNA 58.2 How many of your blood brothers had early onset baldness? (code 00 if none) IT] Number of brothers S8.3 Did any of your blood brothers have a diagnosis of cancer? ON OY S8.4 Haw many of your blood brothers were diagnosed with cancer? code 00 if none and skip to question 89) IT] Number or brothers 585 Did any of your blood brother(s) ever have the following of cancers? (SHOW CARD) • Page 58 of 72 • ~ • 34366 • IO-Number Remember we are talking about your blood brothers--FulJ brothers or half brothers (same mother or fathel) Brother 1 Brother 2 Brother 3 TYPE OF Age at Diagnosis , Age at Diagnosis CANCER: o\PR.o~-r rn p,rr lumber ~IIIIIJ~l Now let's move on to your daughters. S9. How many blood daughters do you have? Do not count step daughters or adopted daughters. Numbe, ofdaughters Ifparticipant has any blood-related daughters: S9.1 Did any of your blood daughters have a diagnosis of polycystic ON ovary syndrome? OY 59.2 How many of your blood daughters were diagnosed with polycystic rJ 0 "CD DA L\ ovary syndrome? (code 00 if none) rn Number ofdaughters ON 59.3 Did any of your blood daughters have a diagnosis of cancer? LADAU6H OY S9.4 How many of your blood daughters were diagnosed with NuNlC.A DAL! cancer? (code 00 if none and skip to question 810) Number ofdaughters 595 Did any of your blood daughter(s) ever have the following of cancers? (SHOWCARDj -. Page 60 of 72 •------_.-_. • • rn 34955 • _ Remember these are blood related daughters DAUGHTER 1 DAUGHTER 2 DAUGHTER J TYPE OF CANCER: Age at Diagnosis "0:, bE.:>T Breast ON OY ODK D:3CJf\"-y Ovary ON OY ODK DZ,ENruM Endometrial ON OY ODK 03L6i>.\i Cervical ON OY ODK 03Tlij ~D Thyroid ON OY ODK Colon, rectum, DZ,WL-UN bowel, intestine ON OY ODK O~IN Skin ON OY 0 DK non-rnelanoma 03 "'-"'-LAN Melanoma ON OY ODK D3L-.-Jf':R.. Liver ON OY a DK D=-UJ Nq Lung ON OY ODK DZ,p,12/'I1 '" -in ON DY ODK 03CO>Je Bone ON OY ODK D3~T();-\ Stomach ON OY ODK Blood} D 3uSLI K.EM leukemia ON OY 0 DK D3BLADDR... Bladder ON OY ODK D3L'/!.H'~ Lymphoma ON O'Y ODK D3HDD"<.r-J Hodgkins ON OY ODK D.3 K.JpoJ"E-i Kidney ON OY ODK D3t'A")LI~...S Pancreas ON OY ODK D3oV'\t Mouth(oral) ON OY ODK V301~Cf\ Other(sp) ON OY ODK -- • page 61 of 72 • • rn 34955 • -"ow let's move on to your sons. 510. How many blood sons do you have? Do not count step sons or adopted sons. []J Nui'I:'lo N Number of sons If participant has any blood~re/atedsons: S10.1 Did any of your blood sons have early onset baldness (before the age of 30)? 510.2 How many of your blood sons had early onset baldness? (code 00 if none) Number ofsons 510.3 Did any of your blood sons have a diagnosis of cancer? ON OY S10.4 How many of your blood sons were diagnosed with cancer? (code 00 if none and skip to Section 1) Number ofsons 510.5 Did any of your blood 50n(8) ever have the following of cancers? (SHOWCARDj - • Page 62 of 72 • ~ • 33624 • •....", Number Remember we are falking about blood related sons. Son 1 Son 2 Son 3 TYPE OF CANCER: Prostate Thyroid Colon, rectum, bowel, intestine Testicles Breast Skin non-melanoma Melanoma Liver Lung . n Bone Stomach Bloodl leukemia Bladder Lymphoma Hodgkins Kidney Pancreas Mouth(oral) Other(sp) • Page 63 0172 • SECTION T • FOR CASES ONLY • 10 Number 11) ~0 (V\ The next set of questions are about the symptoms that led to your diagnosis with ovarian cancer. FOR CASES ONLY: The symptoms of ovarian cancer, such as those listed on this card, are often very subtle (SHOW CARD). T1. First, by just indicating yes or no, did you notice any of these symptoms or changes in your body or ON goloT4 your health before you were diagnosed with ovarian oVC-Ft ':;;'jM cancer? You may not have realized at the time that OY they were symp10ms of your disease. If yes to any symptom, complete T2 and T3. iJ~ Page 64 of 72 • \ I. • • • T2. Did you experience any of these symptoms or changes in your health before you were diagnosed with ovarian cancer, but you did NOT feel at the time that these symptoms were a problem? c. Did you d. If yes, complete d-f. e. what f. what T2a. Symptom b, If yes, dale you first experienced this symptom tell a Dr. Date you told your Dr. or healthcare kind of type of about this provider about this symptom Dr appt ll5 ~A:)ufl rrJ/D~1 ':f!~~d~ttf7DJI o. Gas ON OY ITIIJ ITIIJOffi""cct ,J NIl;>"'f PT/'''LUIN) DR"",,)NP ~",JAU,JP O"ti""r l!Pry,"",,,,,, 1. Nausea ON OY [I] I I ITIIJ 0 N OY LLJ I EB I ITTTl In D'-'~ DR'NO'" ~ r-{212tl,'Af '----'----'----"FrDI Mfv;;J .J ''''8''''''1' 0 N 0 Y ITIIJ 2. Indigestion N OY [I] IH~" LLJ I ITIIJD~ LLJr--f'Q{'·Hi~&~!', I I OR~"; ;/ f!Jf{,JNf r--r'2r tff3fWp :AiCt""", 3. Heartburn ON OY LLJ I LLJ I ITIIJ 0 N OY LLJ I LLJ I ITIIJ LLJ r- u U N f' ,----,I2,rFUU.Jp DR-F"vNf' ODi<.Pvv N f' D1iTY"-'[.J p!7Y..fVJN 4. Freq/urg urination 0 N 0 Y LLJ I IT] I ITIIJ 0 N 0 Y IT] I [I] I ITIIJ LLJ 13//{,JP ~'I3{f{NP Df2.5IRNP DoRl3rR.t-JP DIIET',! eLi.,.) 5. Bowel irregularity 0 N 0 Y I I ITIIJ 0 N 0 Y nII IT]I ITIIJ B3 ~RC<:>~ ~2.tryl"'r CO,.)Nt" u:> DIi.GDNI'Jf' o:r"'iV 6 Constipation 0 N 0 Y I I ITIIJ 0 N 0 Y LLJ I LLJ I LLJLLJ A6r,.JP ~fl~ DAACJIYJI' OOfll"'rs ,---,----,----,12~.iIJ CCFA/f ' DRlY:.FrJP ~ -rJP iii CLF,v HJ 9. Change clothes fit ON OY WIW/ITIIJ ON OY WIW/~rn 10 Decreased Appetite 0 N 0 Y IT]I [I] I ITIIJ 0 N 0 Y [I] I IT]I ITIIJ IT] [I] DflfPr-JP O,APPAlP PRAPPNP DOf',DI'IPI-JP Of<.TVDI'II'JJ I'lPTyPt'/PN Symptoms continue on next page ~~ Page 65 of 72 • i ( • • • c. Did you d. If yes, complete d-f. e. what f. what T2a. Symptom b. If yes, date you first experienced this (ell a Dr. Date you told your Or. or healthcare kind of lype 01 symptom about this provider about this symptom Dr. appt. _ symptom SPp,-, p D I :'> PI' 1'1 P DR.5I'I'Aif' 00 R.~pptJP Oi<.,Ty~FIN, I'I/'Tlt<>Ff'N 11. Severe pelvIc pain 0 N 0 Y IT] I IT] I [IJIJ 0 N 0 Y IT] I IT] I [IJIJ IT] [I] PADNP DTPiOl1 DI "j"'lJffl.. ,--,D,,,J&IJ Of!J,J..oJPfI. '[) blJ f<. ~d:!'mp 8. Weight gain/loss 0 N 0YI~ I I ITIJ] 0N 0Y I I UFt',z Df2Uj=PI<' ~I2CLr If:, 9. Change clothes fit 0N OY B?fn:I I ITIJ] 0N OY I I " D fl Prf t<.. D [)WA P PI<.. " fii (fli'f< {>I'f'il{fI',, 10" Decreased Appelite 0 N 0 Y I I oo=IJ 0 N 0 Y I I tTill Symptoms continue on next page EJ~ Page 67 of 72 • ! ( ( • • • c. Did you d. rt yes, complete d-f. e. what f. what T3a. Symptom b. If yes, date you first experienced this tell a Dr Date you told your Dr. or healthcare kind of type of symptom about this provider about Ihis symptom Dr. appt. symptom 5fPfe.... f' fTf'~ D"'~PPPI( DDtl..SPPP~ Di'Yf'T ~I'I'I' 11. Severe pelvic pain 0 N 0 Y [I] I I LL.L.l.J 0 N 0 Y [I] I [I] I rnrn LlJ i'Avi'~ p'PADf'1i!.. Ol.PADf'12... PDePllOPiZ D,""YjOIIPrifiOP 12 Pelviclabddiscoml ON OY [I] I [I] I rnrn ON OY [I] I [I] I rnrn F6~L-L-6rly [I]/'fn/rnrnDf{t:L~~E8DDR~Lf4/rTTfl7TI LP 13. Feeling full m p,(:'/1PfI.. pffii!;;;iPR pi.fJ8fTlPR. "~~f3P CM~BI1P 14. Abdominal mass ON OY [I] I InI rnrn ON OY I I ~ A B:> w P'" '?~... °"-PI e,~p;>. r-T.Qlr"/'~ 02. p ~1l<3.>f" 15. Abdominal swelling 0 N 0 Y [I] I LlJ I rnrn 0 N 0 Y LLJ I LLJ I rnrn LLJ D5f\j'i'., DTP:>Ai'i'- Df>.&,APiZ~~~ .DrIFT" flJ'!::t.....DYIP 16. Distended abd 0 N 0 Y [I] I [I] I rnrn 0 N 0 Y LLJ I LLJ I rnrn LLJ HfI~PI/.. 0'1 tttrR... D~Hfle,Ft>.. ODe.Ilf\~p~[rIPW8,.j/lF>P 17. Hard abdomen ON OY [I] I Irnrn ON OY [I]/[I]/LLJLLJ BL:Tff<.. orBL.TPf'.. Qi1.e>LTPl<..rrJ0e..e.cTf"itIrrJ 'fiTI5<-Tf" WI3LTP 16. Bloaling 0 N 0 Y [I] [I] rnrn 0 N 0 Y Plcrp- 01:I 0 "Ii!..I DI<.PILfR... mlI I TyPI<.~ 19. Painful intercourse 0 N 0 Y [I] I I rnrn 0 N 0 Y [I] I I ITlITl I Op"f(Z... C?l Ii!.. PWF6PI<..'~ Q="'PI<.. '---'----'----' OF6P tlPtt/6FiH'. 20.0ngoing latigue 0 N 0 Y [I] I I rnrn 0 N 0 Y I I II rnrn I CPFl.fl1- 0 I<.. DRC-Pi<.PR, V 12... c.P<-f'c. 21.Cheslpain/resp ON OY fE} Irnrn ON OY I I I m I O~~ pI( D£D:>ypt<.. OD ".~~~~ f 'SiP 22 Other (sp) 0 N 0 Y I I rnrn 0 N 0 Y [I] I I L-L---'----'----.J I EJ~ Page 66 0172 • ( • • • T4. Before your diagnosis, did you know about the ON KNNOV SG,IJ signs and symptoms of ovarian cancer? OY T5. Did your physician or gynecologist ever tell you ON GyNOJ'::>&N the signs and symptoms of ovarian cancer? OY T6. Before your diagnosis were you actively seeking ON goloT7 ACTvCAe.£ medical care to watch for the disease? OY If YES T6a. What type of care did you have? (SHOW CARD) ogyne exam OCA125 TYPE:CR~ o Transvag ultrasound o Other (sp) T6b. How often did you have these exams? o every year o every 2 years FREG. r=;x.A \VI o every 5 years o Other (sp) T7. Did you go for an annual gynecological exam within ON Gyt-J£xAM the year prior to your ovarian cancer diagnosis? OY Ej~ • Page 69 of 72 • • • T8. What was the primary reason for the doctor visit that led to o Symptoms of ovarian cancer the discovery of your ovarian tumor? (SHOW CARD) o Routine screening, CA125, TVU, etc o Routine gyne exam o Routine health exam o Pregnancy «.EASOVD)( o Birth control o Infertility evaluation o Hysterectomy, (not for ov cal o Other surgery, (op) o Other prob (sp) o Other (sp] T9. What was the date of that doctor visit? ITJ /ITJ /ITOJ MD vl:>D-( ma da y, T10. What was the date of your first surgery for ovarian cancer? ITJ /ITJ /ITOJ OVCASUR 9 ('YES mo da y, T10a. Was the surgery performed because the doctor suspected ON ovarian cancer? fI-1 0 ,sU;:'PCA OY goloT11 T10b. If No, didn't suspect, What disease did your doctor code suspect? OJ MD,5u;5PNH ~~ Page 70 of 72 • I. I • • • T11. Which healthcare provider diagnosed you with ovarian o Gynecological oncologist cancer? (SHOW CARD) o Your obstetrician/gnecologist o PCP, general practitioner o Surgeon T y N [} D;(cA o Infertility specialist o Other (sp) T12. Were you seen by a gynecologic oncologist before your ON (go to T13) 5E6ytJ ONC diagnosis? OY T12a. If yes, seen tiefore diagnosis, date first ITJ I ITJ I ITIIJ 6yiJOI.JC- J S seen mo d. '" T13. Were you seen by a gynecologic oncologist after your ON diagnosis? 6YNOrJC-AF" OY T13a. If yes, seen by gynecologic oncologist, ITJ I ITJ I ITIIJ 6yiJO/>JC.AV date first seen mo d. y, ~~ Page 71 of 72 • I, • .~ SECTION Z: ENDING 27125 • . - ~.- ID Number IONuM Z1. Which number describes the total yearly 00 Less than $6,000 -'0 $25,000 - $34,999 income of your household ·REF MO YR"", before taxes or deductions of any kind? (Include all I 0 $6,000 - $7,999 '" 0 $35,000 - $49,999 sources of income including pensions, L 0 $8,000 - $9,999 '1 0 $50,000 - $69,999 unemployment compensation, interest and dividends.) (SHOW CARD) 30 $10,000 -$11,999 /00 $70,000 - $89,999 '/ 0 $12,000 - $14,999 "0 $90,000 or more 5 0 $15,000 - $19,999''-0 Refused G 0 $20,000 - $24,999 -30 Unknown Z2. How many persons were supported by this income? \NLf-\ JU P ITJ number of persons Z3. If the analysis of this study raises ON additional questions, may we get in touch with you again if we need to? OY Z4. Would you like to receive updates about ON the study or other issues related to ovarian OY cancer? • Page 72 of 72 ..... _--- •