Anthropometric measures and epithelial ovarian cancer risk in the European Prospective Investigation into Cancer and Nutrition.
We examined the associations of measured anthropometric factors, including general and central adiposity and height, with ovarian cancer risk. We also investigated these associations by menopausal status and for specific histological subtypes. Among 226,798 women in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, there were 611 incident cases of primary, malignant, epithelial ovarian cancer diagnosed during a mean 8.9 years of follow-up. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for potential confounders. Compared to women with body mass index (BMI) < 25 kg/m2, obesity (BMI > or = 30 kg/m2) was associated with excess ovarian cancer risk for all women combined (HR = 1.33, 95% CI = 1.05-1.68; p(trend) = 0.02) and postmenopausal women (HR = 1.59, 95% CI = 1.20-2.10; p(trend) = 0.001), but the association was weaker for premenopausal women (HR = 1.16, 95% CI = 0.65-2.06; p(trend) = 0.65). Neither height or weight gain, nor BMI-adjusted measures of fat distribution assessed by waist circumference, waist-hip ratio (WHR) or hip circumference were associated with overall risk. WHR was related to increased risk of mucinous tumors (BMI-adjusted HR per 0.05 unit increment = 1.17, 95% CI = 1.00-1.38). For all women combined, no other significant associations with risk were observed for specific histological subtypes. This large, prospective study provides evidence that obesity is an important modifiable risk factor for epithelial ovarian cancer, particularly among postmenopausal women.
Lahmann
Petra H
PH
Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany.
Cust
Anne E
AE
Friedenreich
Christine M
CM
Schulz
Mandy
M
Lukanova
Annekatrin
A
Kaaks
Rudolf
R
Lundin
Eva
E
Tjønneland
Anne
A
Halkjaer
Jytte
J
Severinsen
Marianne Tang
MT
Overvad
Kim
K
Fournier
Agnès
A
Chabbert-Buffet
Nathalie
N
Clavel-Chapelon
Françoise
F
Dossus
Laure
L
Pischon
Tobias
T
Boeing
Heiner
H
Trichopoulou
Antonia
A
Lagiou
Pagona
P
Naska
Androniki
A
Palli
Domenico
D
Grioni
Sara
S
Mattiello
Amalia
A
Tumino
Rosario
R
Sacerdote
Carlotta
C
Redondo
María-Luisa
ML
Jakszyn
Paula
P
Sánchez
María-José
MJ
Tormo
María-José
MJ
Ardanaz
Eva
E
Arriola
Larraitz
L
Manjer
Jonas
J
Jirström
Karin
K
Bueno-de-Mesquita
H Bas
HB
May
Anne M
AM
Peeters
Petra H M
PH
Onland-Moret
N Charlotte
NC
Bingham
Sheila
S
Khaw
Kay-Tee
KT
Allen
Naomi E
NE
Spencer
Elizabeth
E
Rinaldi
Sabina
S
Slimani
Nadia
N
Chajes
Véronique
V
Michaud
Dominique
D
Norat
Teresa
T
Riboli
Elio
E
D000328:Adult; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D002277:Carcinoma / Q000453:epidemiology* / Q000209:etiology*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008593:Menopause; D008875:Middle Aged; D015999:Multivariate Analysis; D009752:Nutritional Status; D009765:Obesity / Q000150:complications*; D056128:Obesity, Abdominal / Q000150:complications; D016017:Odds Ratio; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D055105:Waist Circumference; D049629:Waist-Hip Ratio