title: Body mass index, physical activity, and mortality in women diagnosed with ovarian cancer: results from the Women's Health Initiative.
abstract: BACKGROUND
  Ovarian cancer is often diagnosed at late stages and consequently the 5-year survival rate is only 44%. However, there is limited knowledge of the association of modifiable lifestyle factors, such as physical activity and obesity on mortality among women diagnosed with ovarian cancer. The purpose of our study was to prospectively investigate the association of (1) measured body mass index (BMI), and (2) self-reported physical activity with ovarian cancer-specific and all-cause mortality in postmenopausal women enrolled in the Women's Health Initiative (WHI).
  
  
  METHODS
  Participants were 600 women diagnosed with primary ovarian cancer subsequent to enrollment in WHI. Exposure data, including measured height and weight and reported physical activity from recreation and walking, used in this analysis were ascertained at the baseline visit for the WHI. Cox proportional hazard regression was used to examine the associations between BMI, physical activity and mortality endpoints.
  
  
  RESULTS
  Vigorous-intensity physical activity was associated with a 26% lower risk of ovarian cancer specific-mortality (HR=0.74; 95% CI: 0.56-0.98) and a 24% lower risk of all-cause mortality (HR=0.76; 95% CI: 0.58-0.98) compared to no vigorous-intensity physical activity. BMI was not associated with mortality.
  
  
  CONCLUSIONS
  Participating in vigorous-intensity physical activity, assessed prior to ovarian cancer diagnosis, appears to be associated with a lower risk of ovarian cancer mortality.
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA. Electronic address: yang.zhou@yale.edu.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: David Geffen School of Medicine, University of California, Los Angeles, Torrance, CA, USA.
authors.forename: Rowan
authors.initials: R
authors.lastname: Chlebowski
authors.affiliation: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University of Buffalo, Buffalo, NY, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: LaMonte
authors.affiliation: University of Arizona Cancer Center, Tucson, AZ, USA.
authors.forename: Jennifer W
authors.initials: JW
authors.lastname: Bea
authors.affiliation: Division of Biostatistics, School of Medicine, University of California, Davis, CA, USA.
authors.forename: Lihong
authors.initials: L
authors.lastname: Qi
authors.affiliation: Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Wallace
authors.affiliation: Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA.
authors.forename: Sayeh
authors.initials: S
authors.lastname: Lavasani
authors.affiliation: Center for Reproductive Medicine, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Brian W
authors.initials: BW
authors.lastname: Walsh
authors.affiliation: School of Public Health, University of Washington, Seattle, WA, USA.
authors.forename: Garnet
authors.initials: G
authors.lastname: Anderson
authors.affiliation: Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
authors.forename: Mara
authors.initials: M
authors.lastname: Vitolins
authors.affiliation: Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
authors.forename: Gloria
authors.initials: G
authors.lastname: Sarto
authors.affiliation: Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA.
authors.forename: Melinda L
authors.initials: ML
authors.lastname: Irwin
mesh_terms: D000368:Aged; D015992:Body Mass Index; D002423:Cause of Death; D015331:Cohort Studies; D015444:Exercise; D005260:Female; D006801:Humans; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications*; D010051:Ovarian Neoplasms / Q000150:complications / Q000401:mortality*; D050177:Overweight / Q000150:complications; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
keywords: Exercise; Mortality; Obesity; Ovarian cancer; Physical activity; Weight