title: Alcohol drinking and epithelial ovarian cancer risk. a systematic review and meta-analysis.
abstract: OBJECTIVE
  In order to provide an updated quantification of the association between alcohol drinking and epithelial ovarian cancer risk, we conducted a meta-analysis of published observational studies.
  
  
  METHODS
  Using PubMed, we performed a literature search of all case-control and cohort studies published as original articles in English up to September 2011. We included 27 observational studies, of which 23 were case-control studies, 3 cohort studies and one pooled analysis of prospective cohort studies, including a total of 16,554 epithelial ovarian cancer cases. We derived pooled meta-analytic estimates using random-effects models.
  
  
  RESULTS
  The pooled relative risk (RR) for any alcohol drinking compared with non/occasional drinking was 1.00 [95% confidence interval (CI), 0.95-1.05]. The RRs were 0.97 (95% CI, 0.92-1.02), 1.03 (95% CI, 0.96-1.11) and 1.09 (95% CI, 0.80-1.50) for light (≤ 1 drink/day), moderate (>1 to <3 drinks) and heavy drinking (≥ 3 drinks/day), respectively. In particular, the pooled RR for invasive epithelial ovarian cancers was 1.00 (95% CI, 0.95-1.06), while for borderline cancers was 0.96 (95% CI, 0.74-1.26). Stratified analyses across cancer histotypes revealed a modest protective effect of alcohol on endometrioid epithelial ovarian tumors (RR=0.82, 95% CI, 0.70-0.96), while no association was found for serous (RR=1.00, 95% CI, 0.84-1.19), mucinous (RR=0.91, 95% CI, 0.78-1.08) and clear cell (RR=0.93, 95% CI, 0.76-1.14) cancers. There was no evidence of publication bias.
  
  
  CONCLUSIONS
  This comprehensive meta-analysis provided no evidence of a material association between alcohol drinking and epithelial ovarian cancer risk.
authors.affiliation: Department of Clinical Medicine and Prevention, Centre of Biostatistics for Clinical Epidemiology, University of Milano-Bicocca, Monza, Italy. matteo.rota@unimib.it
authors.forename: Matteo
authors.initials: M
authors.lastname: Rota
authors.forename: Elena
authors.initials: E
authors.lastname: Pasquali
authors.forename: Lorenza
authors.initials: L
authors.lastname: Scotti
authors.forename: Claudio
authors.initials: C
authors.lastname: Pelucchi
authors.forename: Irene
authors.initials: I
authors.lastname: Tramacere
authors.forename: Farhad
authors.initials: F
authors.lastname: Islami
authors.forename: Eva
authors.initials: E
authors.lastname: Negri
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: Rino
authors.initials: R
authors.lastname: Bellocco
authors.forename: Giovanni
authors.initials: G
authors.lastname: Corrao
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Bagnardi
mesh_terms: D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology*; D000077216:Carcinoma, Ovarian Epithelial; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000209:etiology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors