title: Obesity and the risk of epithelial ovarian cancer: a systematic review and meta-analysis.
abstract: Obesity is a risk factor for several hormone-related cancers but evidence for an effect on risk of epithelial ovarian cancer remains inconclusive. Many studies evaluating this association have had insufficient statistical power to detect modest effects, particularly for histological subtypes of ovarian cancer. We have therefore assembled the published evidence on obesity and ovarian cancer in a systematic literature review and meta-analysis. We identified eligible studies using Medline and manual review of retrieved references, and included all population-based studies that assessed the association between overweight, body mass index (BMI25-29.9) and obesity (BMI30) and histologically confirmed ovarian cancer. Meta-analysis was restricted to those studies that expressed effect as an odds ratio (OR), risk ratio, or standardised incidence ratio and 95% confidence interval (CI). We identified 28 eligible studies, of which 16 on adult obesity and 9 on obesity in early adulthood were suitable for meta-analysis. Overall, 24 of 28 studies reported a positive association between obesity and ovarian cancer, and in 10 this reached statistical significance. The pooled effect estimate for adult obesity was 1.3 (95%CI1.1-1.5) with a smaller increased risk for overweight (OR1.2;95%CI1.0-1.3). The pooled OR was stronger among case-control studies (OR=1.5) than cohort studies (OR=1.1). Overweight/obesity in early adulthood was also associated with an increased risk of ovarian cancer. There was no evidence that the association varied for the different histological subtypes of ovarian cancer. Ovarian cancer should be added to the list of cancers likely to be related to obesity.
authors.affiliation: Cancer and Population Studies Group, Queensland Institute of Medical Research, PO Royal Brisbane Hospital, Herston, Brisbane, Qld 4029, Australia. Catherine.Olsen@qimr.edu.au
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
authors.forename: Adèle C
authors.initials: AC
authors.lastname: Green
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
authors.forename: Shahram
authors.initials: S
authors.lastname: Sadeghi
authors.forename: Fariba
authors.initials: F
authors.lastname: Kolahdooz
authors.forename: Penelope M
authors.initials: PM
authors.lastname: Webb
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D009376:Neoplasms, Hormone-Dependent / Q000209:etiology / Q000473:pathology; D009765:Obesity / Q000150:complications* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000209:etiology* / Q000473:pathology; D017594:Publication Bias; D012307:Risk Factors