title: Dietary fat intake and risk of epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition.
abstract: There are inconsistent and limited data available to assess the relationship between fat intake and risk of epithelial ovarian cancer (EOC). We examined the consumption of total fat, fat sources and fat subtypes in relation to risk of EOC and its major histologic subtypes in the European Prospective Investigation into Cancer and Nutrition which includes incident invasive (n=1095) and borderline (n=96) EOC. Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). In multivariate models, we observed no association with consumption of total fat, animal or plant fat, saturated fat, cholesterol, monounsaturated fat, or fatty fish and risk of invasive EOC. There was, however, an increased risk of invasive EOC in the highest category of intake (Quartile 4 vs. Quartile 1) of polyunsaturated fat (HR=1.22, 95% CI=1.02-1.48, P(trend)=0.02). We did not observe heterogeneity in the risk associations in comparisons of serous and endometrioid histologic subtypes. This study does not support an etiological role for total fat intake in relation to EOC risk; however, based on observations of a positive association between intake of polyunsaturated fat and invasive EOC risk in the current and previous studies, this fat subtype warrants further investigation to determine its potential role in EOC development.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom. Electronic address: m.merritt@imperial.ac.uk.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Merritt
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom.
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.affiliation: Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, N-9037 Tromsø, Norway; Department of Etiological Research, The Cancer Registry of Norway, 0310 Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, Stockholm 17177, Sweden; Folkhälsan Research Centre, Samfundet Folkhälsan, FI-00290 Helsinki, Finland.
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.affiliation: Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110 Ioannina, Greece; Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford OX3 7LF, United Kingdom.
authors.forename: Konstantinos K
authors.initials: KK
authors.lastname: Tsilidis
authors.affiliation: Aarhus University, Department of Public Health, Section for Epidemiology, Bartholins Allé 2 - Building 1260, DK-8000 Aarhus, Denmark.
authors.forename: Kim
authors.initials: K
authors.lastname: Overvad
authors.affiliation: Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.affiliation: Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
authors.forename: Louise
authors.initials: L
authors.lastname: Hansen
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France; Institut Gustave Roussy, F-94805 Villejuif, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Dossus
authors.affiliation: Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Nutrition, Hormones and Women's Health Team, F-94805 Villejuif, France; Univ Paris Sud, UMRS 1018, F-94805 Villejuif, France; Institut Gustave Roussy, F-94805 Villejuif, France.
authors.forename: Guy
authors.initials: G
authors.lastname: Fagherazzi
authors.affiliation: Cancer Epidemiology Centre, Cancer Council of Victoria, 615 St. Kilda Road, Melbourne, Victoria 3004, Australia; Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Victoria 3010, Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Baglietto
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
authors.forename: Renée T
authors.initials: RT
authors.lastname: Fortner
authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ose
authors.affiliation: German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Department of Epidemiology, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
authors.forename: Annika
authors.initials: A
authors.lastname: Steffen
authors.affiliation: German Institute of Human Nutrition, Potsdam-Rehbrücke (DIfE), Department of Epidemiology, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany.
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
authors.affiliation: Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece; Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece.
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.affiliation: Hellenic Health Foundation, 13 Kaisareias Street, Athens GR-115 27, Greece; Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Trichopoulos
authors.affiliation: Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens GR-115 27, Greece; Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA; Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Mikras Asias 75, Goudi, GR-115 27 Athens, Greece.
authors.forename: Pagona
authors.initials: P
authors.lastname: Lagiou
authors.affiliation: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Ponte Nuovo Palazzina 28 A "Mario Fiori", Via delle Oblate 4, 50141 Florence, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Masala
authors.affiliation: Epidemiology and Prevention Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Via Venezian, 1, 20133 Milano, Italy.
authors.forename: Sabina
authors.initials: S
authors.lastname: Sieri
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Corso Umberto I, 40, 80138 Naples, Italy.
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.affiliation: Cancer Registry and Histopathology Unit, "Civic-M.P.Arezzo" Hospital, ASP, Via Dante N° 109, 97100 Ragusa, Italy.
authors.forename: Rosario
authors.initials: R
authors.lastname: Tumino
authors.affiliation: Unit of Cancer Epidemiology, AO Citta' della Salute e della Scienza-University of Turin and Center for Cancer Prevention (CPO-Piemonte), Via Santena 7, 10126 Turin, Italy; Human Genetics Foundation (HuGeF), Via Nizza 52, 10126 Turin, Italy.
authors.forename: Carlotta
authors.initials: C
authors.lastname: Sacerdote
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom; National Institute for Public Health and the Environment (RIVM), PO Box 1, 3720 BA Bilthoven, The Netherlands; Department of Gastroenterology and Hepatology, University Medical Centre, Heidelberglann 100, 3584 CX Utrecht, The Netherlands.
authors.forename: H B As
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Huispost Str. 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: N Charlotte
authors.initials: NC
authors.lastname: Onland-Moret
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Huispost Str. 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Petra H
authors.initials: PH
authors.lastname: Peeters
authors.affiliation: Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Postboks 1046 Blindern, 0317 Oslo, Norway.
authors.forename: Anette
authors.initials: A
authors.lastname: Hjartåker
authors.affiliation: Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, N-9037 Tromsø, Norway.
authors.forename: Inger Torhild
authors.initials: IT
authors.lastname: Gram
authors.affiliation: Public Health Directorate, Health and Health Care Services Council, C/ Ciriaco Miguel Virgil no 9, CP 33006 Oviedo, Asturias, Spain.
authors.forename: J Ramón
authors.initials: JR
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authors.affiliation: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Program, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology (ICO), Avda Gran Via 199-203, L'Hospitalet del Llobregat, 08907 Barcelona, Spain.
authors.forename: Mireia
authors.initials: M
authors.lastname: Obón-Santacana
authors.affiliation: Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria de Granada (Granada.ibs), Cuesta del Observatorio, 4, Campus Universitario de Cartuja, 18080 Granada, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante 11, 30008 Murcia, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: Huerta Castaño
authors.affiliation: CIBER de Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029 Madrid, Spain; Navarre Public Health Institute, Leyre 15, 31003 Pamplona, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: Public Health Division of Gipuzkoa, BioDonostia Research Institute, Health Department of Basque Region, Avenida de Navarra, 4-20013 Donostia, San Sebastian, Spain.
authors.forename: Saioa
authors.initials: S
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authors.affiliation: Department of Clinical Sciences in Malmö, Lund University, 20502 Malmö, Sweden.
authors.forename: Emily
authors.initials: E
authors.lastname: Sonestedt
authors.affiliation: Department of Clinical Sciences, Obstetrics and Gynecology, Umeå University, SE-901 87 Umeå, Sweden; Department of Public Health and Clinical Medicine, Nutritional Research, Umeå University, SE-901 87 Umeå, Sweden.
authors.forename: Annika
authors.initials: A
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authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, SE-901 87 Umeå, Sweden.
authors.forename: Eva
authors.initials: E
authors.lastname: Lundin
authors.affiliation: University of Cambridge, School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0SP, United Kingdom.
authors.forename: Kay-Tee
authors.initials: KT
authors.lastname: Khaw
authors.affiliation: MRC Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, PO Box 285, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, United Kingdom.
authors.forename: Nicholas
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authors.affiliation: Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Oxford OX3 7LF, United Kingdom.
authors.forename: Ruth C
authors.initials: RC
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authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69372 Lyon Cedex 08, France.
authors.forename: Sabina
authors.initials: S
authors.lastname: Rinaldi
authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69372 Lyon Cedex 08, France.
authors.forename: Isabelle
authors.initials: I
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authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert-Thomas, 69372 Lyon Cedex 08, France.
authors.forename: Veronique
authors.initials: V
authors.lastname: Chajes
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, London W2 1PG, United Kingdom.
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mesh_terms: D000328:Adult; D000077216:Carcinoma, Ovarian Epithelial; D004041:Dietary Fats / Q000008:administration & dosage* / Q000009:adverse effects; D004042:Dietary Fats, Unsaturated / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009375:Neoplasms, Glandular and Epithelial / Q000453:epidemiology* / Q000209:etiology; D010051:Ovarian Neoplasms / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk
chemical_list: D004041:Dietary Fats; D004042:Dietary Fats, Unsaturated
keywords: Dietary fats; Ovarian cancer; Serous neoplasms; Unsaturated dietary fats