title: Nutrient-wide association study of 57 foods/nutrients and epithelial ovarian cancer in the European Prospective Investigation into Cancer and Nutrition study and the Netherlands Cohort Study.
abstract: BACKGROUND
  Studies of the role of dietary factors in epithelial ovarian cancer (EOC) development have been limited, and no specific dietary factors have been consistently associated with EOC risk.
  
  
  OBJECTIVE
  We used a nutrient-wide association study approach to systematically test the association between dietary factors and invasive EOC risk while accounting for multiple hypothesis testing by using the false discovery rate and evaluated the findings in an independent cohort.
  
  
  METHODS
  We assessed dietary intake amounts of 28 foods/food groups and 29 nutrients estimated by using dietary questionnaires in the EPIC (European Prospective Investigation into Cancer and Nutrition) study (n = 1095 cases). We selected 4 foods/nutrients that were statistically significantly associated with EOC risk when comparing the extreme quartiles of intake in the EPIC study (false discovery rate = 0.43) and evaluated these factors in the NLCS (Netherlands Cohort Study; n = 383 cases). Cox regression models were used to estimate HRs and 95% CIs.
  
  
  RESULTS
  None of the 4 dietary factors that were associated with EOC risk in the EPIC study (cholesterol, polyunsaturated and saturated fat, and bananas) were statistically significantly associated with EOC risk in the NLCS; however, in meta-analysis of the EPIC study and the NLCS, we observed a higher risk of EOC with a high than with a low intake of saturated fat (quartile 4 compared with quartile 1; overall HR: 1.21; 95% CI: 1.04, 1.41).
  
  
  CONCLUSIONS
  In the meta-analysis of both studies, there was a higher risk of EOC with a high than with a low intake of saturated fat.
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; m.merritt@imperial.ac.uk.
authors.forename: Melissa A
authors.identifier: http://orcid.org/0000-0002-5067-6119
authors.initials: MA
authors.lastname: Merritt
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;
authors.forename: Ioanna
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authors.affiliation: Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands;
authors.forename: Piet A
authors.initials: PA
authors.lastname: van den Brandt
authors.affiliation: Department of Epidemiology, GROW School for Oncology and Developmental Biology, Maastricht University, Maastricht, Netherlands;
authors.forename: Leo J
authors.initials: LJ
authors.lastname: Schouten
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece;
authors.forename: Konstantinos K
authors.initials: KK
authors.lastname: Tsilidis
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway; Department of Research, Cancer Registry of Norway, Oslo, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Genetic Epidemiology Group, Folkhälsan Research Center, Helsinki, Finland;
authors.forename: Elisabete
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authors.affiliation: Department of Biomedical Informatics, Harvard Medical School, Boston, MA;
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authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark;
authors.forename: Anne
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authors.affiliation: Danish Cancer Society Research Center, Copenhagen, Denmark;
authors.forename: Louise
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authors.affiliation: Department of Public Health, Section for Epidemiology, Aarhus University, Aarhus, Denmark;
authors.forename: Kim
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authors.affiliation: Centre for Research in Epidemiology and Population Health, Inserm (Institut National de la Santé et de la Recherche Médicale), Villejuif Cedex, France; Univ Paris Sud, Villejuif, France; Gustave Roussy, Villejuif, France;
authors.forename: Mathilde
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authors.affiliation: Centre for Research in Epidemiology and Population Health, Inserm (Institut National de la Santé et de la Recherche Médicale), Villejuif Cedex, France; Univ Paris Sud, Villejuif, France; Gustave Roussy, Villejuif, France;
authors.forename: Laureen
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authors.affiliation: Centre for Research in Epidemiology and Population Health, Inserm (Institut National de la Santé et de la Recherche Médicale), Villejuif Cedex, France; Univ Paris Sud, Villejuif, France; Gustave Roussy, Villejuif, France;
authors.forename: Marie-Christine
authors.initials: MC
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authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center [Deutsches Krebsforschungszentrum (DKFZ)], Heidelberg, Germany;
authors.forename: Renée T
authors.initials: RT
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authors.affiliation: Division of Cancer Epidemiology, German Cancer Research Center [Deutsches Krebsforschungszentrum (DKFZ)], Heidelberg, Germany;
authors.forename: Rudolf
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authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;
authors.forename: Krasimira
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authors.affiliation: Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Nuthetal, Germany;
authors.forename: Heiner
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authors.affiliation: Hellenic Health Foundation, Athens, Greece; Bureau of Epidemiologic Research, Academy of Athens, Athens, Greece;
authors.forename: Antonia
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authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA; Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece;
authors.forename: Pagona
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authors.affiliation: Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, Athens, Greece;
authors.forename: Christina
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authors.affiliation: Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute-Istituto per lo Studio e la Prevenzione Oncologica (ISPO), Florence, Italy;
authors.forename: Domenico
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authors.lastname: Palli
authors.affiliation: Epidemiology and Prevention Unit, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Nazionale dei Tumori, Milano, Italy;
authors.forename: Vittorio
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authors.affiliation: Unit of Epidemiology, Regional Health Service, Azienda Sanitaria Locale (ASL) TO3, Grugliasco, Italy; Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy;
authors.forename: Fulvio
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authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Federico II University, Naples, Italy;
authors.forename: Amalia
authors.initials: A
authors.lastname: Mattiello
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department for Determinants of Chronic Diseases, National Institute for Public Health and the Environment [Rijksinstituut voor Volksgezondheid en Milieu (RIVM)], Bilthoven, Netherlands; Department of Gastroenterology and Hepatology and Department of Social & Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;
authors.forename: H Bas
authors.initials: HB
authors.lastname: Bueno-de-Mesquita
authors.affiliation: Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, 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, London, United Kingdom; Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands;
authors.forename: Petra H
authors.initials: PH
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authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway;
authors.forename: Guri
authors.initials: G
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authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway;
authors.forename: Mie
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authors.forename: Mireia
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authors.affiliation: Escuela Andaluza de Salud Pública. Instituto de Investigación Biosanitaria ibs.GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Granada, Spain; CIBER de Epidemiología y Salud Pública, Madrid, Spain;
authors.forename: María-José
authors.initials: MJ
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authors.affiliation: CIBER de Epidemiología y Salud Pública, Madrid, Spain; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain;
authors.forename: José M
authors.initials: JM
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authors.affiliation: CIBER de Epidemiología y Salud Pública, Madrid, Spain; Navarra Public Health Institute, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA) Pamplona, Spain;
authors.forename: Aurelio
authors.initials: A
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authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden;
authors.forename: Joana A
authors.initials: JA
authors.lastname: Dias
authors.affiliation: Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden;
authors.forename: Emily
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authors.affiliation: Department of Clinical Sciences, Obstetrics and Gynecology, Department of Public Health and Clinical Medicine, Nutritional Research and.
authors.forename: Annika
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authors.affiliation: Department of Medical Biosciences, Pathology, Umeå University, Umeå, Sweden;
authors.forename: Eva
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authors.affiliation: Medical Research Council Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom;
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Wareham
authors.affiliation: Cambridge Institute of Public Health, University of Cambridge, Cambridge, United Kingdom;
authors.forename: Kay-Tee
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authors.forename: Ruth C
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authors.forename: Pietro
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authors.lastname: Ferrari
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;
authors.forename: Elio
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authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom;
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mesh_terms: D000328:Adult; D000368:Aged; D000077216:Carcinoma, Ovarian Epithelial; D015331:Cohort Studies; D004032:Diet / Q000009:adverse effects*; D004041:Dietary Fats / Q000009:adverse effects*; D005227:Fatty Acids / Q000009:adverse effects*; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009375:Neoplasms, Glandular and Epithelial / Q000209:etiology*; D009426:Netherlands; D010051:Ovarian Neoplasms / Q000209:etiology*; D012307:Risk Factors
chemical_list: D004041:Dietary Fats; D005227:Fatty Acids
keywords: diet; nutrition; ovarian cancer; prospective cohort; saturated fat; serous